When I began my Orthopaedic Sportsmedicine practice in 1985 ACL reconstruction was generally reserved for young athletes. Over the years the acceptable age for reconstruction has gradually increased. Several studies have shown good outcomes in patients in their 50s. But what about even older individuals? There has been very little data on patients over 60 years of age. However, a recent European study looked at a cohort of a dozen patients between 60 and 63 years of age with no significant arthritic changes in their knee at presentation. All patients had restoration of knee stability by ACLR, with no major complications. 10 of the 12 patients resumed their prior sports activities. Follow-up was 2-6 years and there was no significant progression of arthritis. Ratings were greatly improved overall. While all patients in their 60s are not candidates this study shows that for a selected group in this age range ACL reconstruction is beneficial.
In my own experience, even older patients with moderate arthrosis have benefitted from ACL reconstruction, usually with a reduction in their arthritic symptoms. While I tell all such patients that the procedure may worsen their arthritis, I have never seen it happen. I would also note that all patients had hamstring grafts. Thus the morbidity of graft harvest was also not an obstacle to a complication-free good result.
