{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T08:58:55Z","timestamp":1778144335841,"version":"3.51.4"},"reference-count":43,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2020,4,1]],"date-time":"2020-04-01T00:00:00Z","timestamp":1585699200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2020,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>There is no consensus regarding the best treatment approach for middle-aged patients with anterior cruciate ligament (ACL) injuries. Chronic ACL-deficient knees are often associated with instability as well as secondary meniscal and cartilage lesions. ACL reconstruction (ACLR) has achieved satisfactory outcomes in younger patients; however, the effectiveness and safety of ACLR in middle-aged patients remain uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To compare the patient-reported functional scores, arthrometric outcomes, and complications of primary ACLR between older (\u226550 years) and younger (&lt;50 years) patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Systematic review; Level of evidence, 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a systematic review of cohort studies that compared the clinical outcomes of ACLR between patients aged \u226550 years and those aged &lt;50 years. The Cochrane Central Register of Controlled Trials, Embase, and MEDLINE databases were searched for relevant studies. The Methodological Index for Non-randomized Studies (MINORS) criteria was used to assess the risk of bias and conducted a random-effects meta-analysis to combine the data, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate the overall quality of the body of retrieved evidence. The primary outcome was knee functional outcomes, and secondary outcomes were arthrometric outcomes of ACLR and complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>This study included 4 retrospective cohort studies with a total of 287 participants (129 in the older group and 158 in the younger group). All included studies reported significant improvements in clinical outcomes in both groups after ACLR. No significant differences were noted in the improvement of International Knee Documentation Committee (IKDC) scores (mean difference [MD], 0.20 [95% CI, \u22122.65 to 3.05]; P = .89) and Lysholm scores (MD, \u22121.98 [95% CI, \u22126.93 to 2.98]; P = .43) between the 2 groups. No significant differences were observed in anteroposterior stability or risk of complications between the groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>ACLR may be performed in middle-aged patients (\u226550 years) without concern for inferior clinical and arthrometric results compared with younger patients (&lt;50 years).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2325967120915698","type":"journal-article","created":{"date-parts":[[2020,4,29]],"date-time":"2020-04-29T10:33:39Z","timestamp":1588156419000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":25,"title":["Anterior Cruciate Ligament Reconstruction in Patients Older Than 50 Years: A Systematic Review and Meta-analysis"],"prefix":"10.1177","volume":"8","author":[{"given":"Chong-Wei","family":"Tan","sequence":"first","affiliation":[{"name":"Division of Sports Medicine, Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Puzi, Taiwan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei-Hsiu","family":"Hsu","sequence":"additional","affiliation":[{"name":"Division of Sports Medicine, Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Puzi, Taiwan."},{"name":"College of Medicine, Chang Gung University, Taoyuan, Taiwan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pei-An","family":"Yu","sequence":"additional","affiliation":[{"name":"Division of Sports Medicine, Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Puzi, Taiwan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi-Lung","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Sports Medicine, Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Puzi, Taiwan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liang-Tseng","family":"Kuo","sequence":"additional","affiliation":[{"name":"Division of Sports Medicine, Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Puzi, Taiwan."},{"name":"College of Medicine, Chang Gung University, Taoyuan, Taiwan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ching-Chi","family":"Chi","sequence":"additional","affiliation":[{"name":"College of Medicine, Chang Gung University, Taoyuan, Taiwan."},{"name":"Department of Dermatology, Chang Gung Memorial Hospital, Taoyuan, Taiwan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dokyung","family":"Kim","sequence":"additional","affiliation":[{"name":"School of Medicine, Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geon","family":"Park","sequence":"additional","affiliation":[{"name":"School of Medicine, Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,4,29]]},"reference":[{"key":"bibr1-2325967120915698","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-003-0368-5"},{"key":"bibr2-2325967120915698","doi-asserted-by":"publisher","DOI":"10.1016\/j.annrmp.2004.05.015"},{"key":"bibr3-2325967120915698","doi-asserted-by":"publisher","DOI":"10.1177\/2325967117729659"},{"key":"bibr4-2325967120915698","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517730072"},{"key":"bibr5-2325967120915698","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2007.03.094"},{"key":"bibr6-2325967120915698","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.90B11.21210"},{"key":"bibr7-2325967120915698","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"bibr8-2325967120915698","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-016-4097-y"},{"key":"bibr9-2325967120915698","doi-asserted-by":"publisher","DOI":"10.1177\/03635465990270062501"},{"key":"bibr10-2325967120915698","unstructured":"GRADEpro GDT: GRADEpro Guideline Development Tool [software]. 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