{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T22:48:07Z","timestamp":1781650087997,"version":"3.54.5"},"reference-count":59,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,4,3]],"date-time":"2019-04-03T00:00:00Z","timestamp":1554249600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,4,3]],"date-time":"2019-04-03T00:00:00Z","timestamp":1554249600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To report clinical and functional results of ACL reconstruction in patients over 50 years old and investigate the influence of surgery on osteoarthritis progression in this cohort of patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review was performed on PubMed, Scopus, Google scholar, Cochrane library and EMBASE, using a strategy search design to collect clinical studies reporting outcomes of ACL reconstruction in patients aged 50 years or older. The primary outcome measure was clinical and functional results, including failure rate defined as reoperation for revision ACL surgery or conversion to total knee arthroplasty; secondary outcomes included radiological findings, expressed according to the validated grading score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 16 studies were found suitable and included. Overall, 470 arthroscopic ACL reconstructions were performed in 468 patients (278\u00a0males, 190 females), with a mean age of 53.6 years (50\u201375 years). The total failure rate, described as reoperation for revision ACL surgery was 2.7% (10\u00a0knees), ranging from 0 to 14.3% in the selected studies. All papers reviewed showed a statistically significant improvement of clinical and functional scores at final follow\u2010up, comparable to younger control group, when reported. Post\u2010operative objective stability testing with KT\u20101000 arthrometer device or equivalent was performed in seven studies, with a mean side\u2010to\u2010side difference of 2.2\u00a0mm (0.2\u20132.7\u00a0mm). Radiographic signs of progression of osteoarthritis were reported in six studies, where severe signs of degeneration (grade 3 or 4 according Kellgren\u2013Lawrence or Ahlb\u00e4ck classification) shifted from 4 out of 216\u00a0knees (1.9%) before surgery to 28 out of 187\u00a0knees (15%) following ACL reconstruction, after a mean period of follow\u2010up ranging from 32 to 64\u00a0months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ACL reconstruction in patients older than 50 years is a safe procedure with good results that are comparable to those of younger patients previously reported. Age itself is not a contraindication to ACL surgery because physiological age, clinical symptoms and functional requests are more important than chronological age in decision process. Since cohort size in the present study is not large enough, and taking into account the high occurrence of concomitant meniscal and chondral lesions, more high\u2010quality studies are necessary to draw definitive conclusions about development of osteoarthritis of the knee after ACL surgery in these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-019-05450-1","type":"journal-article","created":{"date-parts":[[2019,4,4]],"date-time":"2019-04-04T01:58:37Z","timestamp":1554343117000},"page":"3679-3691","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Age over 50 years is not a contraindication for anterior cruciate ligament reconstruction"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4672-0778","authenticated-orcid":false,"given":"Giuseppe Gianluca","family":"Costa","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> II Orthopaedic Clinic and Biomechanics Laboratory IRCCS Istituto Ortopedico Rizzoli Via di Barbiano n. 1\/10 40136 Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Grassi","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> II Orthopaedic Clinic and Biomechanics Laboratory IRCCS Istituto Ortopedico Rizzoli Via di Barbiano n. 1\/10 40136 Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Perelli","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Universit\u00e0 Cattolica del Sacro Cuore\u2010Fondazione Poliambulanza Via Bissolati n. 57 25124 Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Agr\u00f2","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> II Orthopaedic Clinic and Biomechanics Laboratory IRCCS Istituto Ortopedico Rizzoli Via di Barbiano n. 1\/10 40136 Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Bozzi","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Universit\u00e0 Cattolica del Sacro Cuore\u2010Fondazione Poliambulanza Via Bissolati n. 57 25124 Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirco","family":"Lo Presti","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> II Orthopaedic Clinic and Biomechanics Laboratory IRCCS Istituto Ortopedico Rizzoli Via di Barbiano n. 1\/10 40136 Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Zaffagnini","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> II Orthopaedic Clinic and Biomechanics Laboratory IRCCS Istituto Ortopedico Rizzoli Via di Barbiano n. 1\/10 40136 Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,4,3]]},"reference":[{"key":"e_1_2_8_2_2","first-page":"7","article-title":"Osteoarthrosis of the knee. 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