PMID- 35247996 OWN - NLM STAT- MEDLINE DCOM- 20220308 LR - 20220315 IS - 1471-2474 (Electronic) IS - 1471-2474 (Linking) VI - 23 IP - 1 DP - 2022 Mar 5 TI - Clinical and functional outcomes of isolated posterior cruciate ligament reconstruction in patients over the age of 40 years. PG - 210 LID - 10.1186/s12891-022-05151-w [doi] LID - 210 AB - BACKGROUND: To assess clinical and functional outcomes of patients aged 40 years or older receiving PCL reconstruction surgery. METHODS: All patients older than 40 years with isolated PCL rupture who underwent PCL reconstruction surgery were enrolled into the retrospective study. Associated meniscal injuries, osteochondral lesions, postoperative complications, and the rate of return to the preinjury level of activity were extracted. Outcomes included International Knee Documentation Committee (IKDC) subjective score, Lysholm score, and Tegner activity score. The minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) were used to evaluate the clinically relevant value of PCL reconstruction in this population. RESULTS: In total, 41 patients with a mean age of 51.7 years were included. The mean follow-up time was 32.8 months. Associated lesions included meniscal injuries (48.8%) and osteochondral lesions (97.6%). Improvement in the IKDC score (from 46.5 preoperatively to 79.0 postoperatively, p < 0.0001), Lysholm score (from 65.5 to 88.3, p < 0.0001), and Tegner activity score (from 2.3 to 4.0, p < 0.0001) was recorded. The clinically relevant value based on the MCID showed that 34 of 41 patients (82.9%) had a DeltaIKDC score exceeding 16.8; all patients (100%) showed a DeltaLysholm score exceeding 8.9; and 35 of 41 patients (85.4%) showed a DeltaTegner activity score exceeding 0.5. Regarding the PASS, none of the patients had an IKDC score exceeding 75.9 preoperatively, whereas 27 of 41 patients (65.9%) had a score of more than 75.9 postoperatively. All patient had >/= grade II knee instability preoperatively. Postoperatively, 36 patients (87.8%) had no significant joint translation, and 5 patients (12.2%) had grade I instability. Twenty-one patients (51.2%) returned to their preinjury level of activity. Five patients (12.2%) developed Ahlback grade I radiographic osteoarthritis. No rerupture or other major perioperative complications were reported. CONCLUSIONS: PCL reconstruction is a reliable surgery for middle-aged patients suffering from persistent instability even after failed conservative treatment, with significant improvement in patient-reported outcomes that exceeded MCID in the majority of patients, restoration of subjective instability, and approximately half of the patients returned to preinjury activity levels. LEVEL OF EVIDENCE: Level IV, therapeutic case series. CI - (c) 2022. The Author(s). FAU - Liu, Chia-Hung AU - Liu CH AD - Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan. AD - Comprehensive Sports Medicine Center, Chang Gung Memorial Hospital, Linkou, Taiwan. FAU - Chiu, Chih-Hao AU - Chiu CH AD - Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan. AD - Comprehensive Sports Medicine Center, Chang Gung Memorial Hospital, Linkou, Taiwan. FAU - Chang, Shih-Sheng AU - Chang SS AD - Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan. AD - Comprehensive Sports Medicine Center, Chang Gung Memorial Hospital, Linkou, Taiwan. FAU - Yeh, Wen-Ling AU - Yeh WL AD - Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan. AD - Comprehensive Sports Medicine Center, Chang Gung Memorial Hospital, Linkou, Taiwan. FAU - Chen, Alvin Chao-Yu AU - Chen AC AD - Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan. AD - Comprehensive Sports Medicine Center, Chang Gung Memorial Hospital, Linkou, Taiwan. FAU - Hsu, Kuo-Yao AU - Hsu KY AD - Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan. AD - Comprehensive Sports Medicine Center, Chang Gung Memorial Hospital, Linkou, Taiwan. FAU - Weng, Chun-Jui AU - Weng CJ AD - Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan. jim_weng@hotmail.com. AD - Comprehensive Sports Medicine Center, Chang Gung Memorial Hospital, Linkou, Taiwan. jim_weng@hotmail.com. FAU - Chan, Yi-Sheng AU - Chan YS AD - Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan. chan512@adm.cgmh.org.tw. AD - Comprehensive Sports Medicine Center, Chang Gung Memorial Hospital, Linkou, Taiwan. chan512@adm.cgmh.org.tw. LA - eng PT - Journal Article DEP - 20220305 PL - England TA - BMC Musculoskelet Disord JT - BMC musculoskeletal disorders JID - 100968565 SB - IM MH - Adult MH - *Anterior Cruciate Ligament Injuries/surgery MH - *Anterior Cruciate Ligament Reconstruction/adverse effects MH - Follow-Up Studies MH - Humans MH - *Joint Instability/surgery MH - Knee Joint/surgery MH - Middle Aged MH - *Posterior Cruciate Ligament/surgery MH - *Posterior Cruciate Ligament Reconstruction MH - Retrospective Studies MH - Treatment Outcome PMC - PMC8897902 OTO - NOTNLM OT - Clinical outcomes OT - Older patients OT - Posterior cruciate ligament OT - Reconstruction COIS- The authors declare no conflict of interest. EDAT- 2022/03/07 06:00 MHDA- 2022/03/09 06:00 PMCR- 2022/03/05 CRDT- 2022/03/06 20:24 PHST- 2021/12/12 00:00 [received] PHST- 2022/02/24 00:00 [accepted] PHST- 2022/03/06 20:24 [entrez] PHST- 2022/03/07 06:00 [pubmed] PHST- 2022/03/09 06:00 [medline] PHST- 2022/03/05 00:00 [pmc-release] AID - 10.1186/s12891-022-05151-w [pii] AID - 5151 [pii] AID - 10.1186/s12891-022-05151-w [doi] PST - epublish SO - BMC Musculoskelet Disord. 2022 Mar 5;23(1):210. doi: 10.1186/s12891-022-05151-w.