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Author Topic: Is there an age limit for ACL reconstruction?  (Read 1552 times)

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Offline Audice

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Re: Is there an age limit for ACL reconstruction?
« Reply #15 on: September 27, 2018, 12:37:02 PM »
Vickster, just to clear the record. At 67 I was not only riding my horse daily but was mucking stalls at the farm & walking my 4 big dogs daily as well. I can assure you I was fitter than most 67 year olds & assuredly was in better shape than my young orthopod who was a sports medicine specialist.

He was disbelieving when he told me I needed no physical therapy as whatever I was doing had my knee sufficiently strong. Within a month of the injury I was back to riding my horse again every day.
April, 2005 - ACL rupture, medial meniscus tear within posterior horn to articular surface, abnormal signal within lateral meniscus, partial tear MCL, bone contusions tibia/fibula, Baker's cyst.
No repairs.

Offline Vickster

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Re: Is there an age limit for ACL reconstruction?
« Reply #16 on: September 27, 2018, 12:44:49 PM »
Indeed I donít doubt that, but 10-15 years ago, Iíd think the medical profession looked at age not the individual. Technology and surgical technique has certainly moved on. How many ACLs were done arthroscopically rather than open for example. I had a tennis elbow repair just 6 years ago. I have a 5 cm scar. Now it can be done keyhole. I also had disc surgery 25 years ago and have a 15cm scar, again keyhole now, 3cm scar

Some surgeons judging by the OP are still reticent based on age.

Surgeons do construct ACLs on the NHS in those in their 60s, hence suggesting the OP gets a second opinion as to whether reconstruction is appropriate.  The potential risks of not repairing are well documented in terms of further damage if the knee is unstable
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline gazkitch

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Re: Is there an age limit for ACL reconstruction?
« Reply #17 on: September 27, 2018, 03:46:29 PM »
I managed to contact my NHS OS via his secretary at the Yorkshire Knee Clinic. I wanted to know if I could pay to just get my meniscus fixed and remain on the NHS list for ACL reconstruction. The reply I got back was ďI have just reviewed his scans. If he requires a meniscal repair it is more than likely to fail if he doesnít have an ACL reconstruction at the same time. I would very much recommend an ACL and reconstruction at the same time for that reason.Ē

I am now totally confused, as this seems to totally contradict what he has said previously?!


Offline BornToRun

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Re: Is there an age limit for ACL reconstruction?
« Reply #18 on: September 27, 2018, 05:42:36 PM »
Iím obviously not an expert, but itís also my understanding that meniscus repairs (rather than trims) work better in conjunction with ACL reconstruction because: 1. If you fix the meniscus but not the ACL, the instability of the ACL deficient knee puts pressure on the meniscus and makes the repair less likely to work; 2. The increased bleeding in the joint from the ACL reconstruction helps the meniscus repair better.
How to square that with his refusal to operate on your ACL until you have more flex Iím not sure - given that the lack of flex could be caused by the meniscus tear. Hence why I concurred on getting a second opinion, because all this seems very confusing. On top of that I understand that the sooner the meniscus is repaired after the injury, the higher the chances of success - correct me if Iím wrong Vickster.
Sorry to throw the cat amongst the pidgeons, hope I havenít made it all even more confusing!
6 Mar 2018 - skiing fall, ACL rupture, MCL and LCL sprain, lateral meniscus tear and bone bruising
13 Apr 2018 - ACL reconstruction with hamstring autograft, small meniscus repair

Offline Vickster

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Re: Is there an age limit for ACL reconstruction?
« Reply #19 on: September 27, 2018, 07:09:04 PM »
From what I understand, it would be unusual for a meniscus to be stitched back together in an 'older' patient (the meniscus actually starts to degenerate from age 30!) and so a complex tear would likely only be trimmable to a stable edge, freeing any trapped in the joint causing locking/ROM inhibition

It does seem that your Consultant isn't sure what he plans to do in your case / what he said he'd do or not do.  Do you have a copy of his letter to your GP to see what he has said?

If he's part of a specific private group/consortium and you plan to get a second opinion privately, perhaps seek a surgeon who has a practice elsewhere to avoid any conflicts.  Perhaps your GP can advise
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Deb1966

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Re: Is there an age limit for ACL reconstruction?
« Reply #20 on: October 20, 2018, 07:55:54 PM »
I am in West Sussex. There is not an age limit, it's decided by your activity levels, how unstable the knee is and whether it is impacting on your daily life. I would ask for a second opinion. Good luck.















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