Allograft Anterior Cruciate Ligament Reconstruction in Patients aged 40 and Older: Patient Reported Outcomes and a Patient Acceptable Symptom State.

Purpose To evaluate patient satisfaction, re-tear rates, and patient reported outcomes (PROs) in patients aged 40 and older undergoing allograft anterior cruciate ligament reconstruction (ACLR). The secondary goal was to compare these parameters between groups of patients with intact versus failed grafts, and to evaluate these in relation to a historically reported International Knee Documentation Committee (IKDC) patient acceptable symptoms state (PASS) score. Methods Records of patients aged 40 and older who underwent ACLR between 2005-2016 at a single institution with a minimum 2-year follow-up were retrospectively reviewed. Patient reported satisfaction, outcome scores, and failure rates were analyzed. The rate of achieving a previously defined IKDC PASS score based on younger cohorts was reported, and an updated PASS threshold for older patients was calculated. Results 201 patients were included with a mean age of 48.6 years (range, 40-68) and mean follow-up of 6.2 years (range, 2.8-11.2). 182 (90.5%) patients reported satisfaction following surgery. 16 (8.0%) patients went on to fail their ACLR, 10 of which underwent revision ACLR. The median IKDC score in the intact ACLR group was 86.2, compared to 66.7 in the failure group (p Conclusion Patients aged 40 and older who underwent allograft ACLR had an 8.0% failure rate at a mean follow-up of 6 years. Graft failure in patients aged 40 and older was associated with worse PROs. The majority of patients achieved the historically reported IKDC PASS threshold. Additionally, an updated age appropriate IKDC PASS score of 66.7 was calculated to aid in future ACLR studies assessing older patients.