50 is the new 30
‘Fifty’ is the new ‘thirty’, I’m told. In prior generations, people were more apt to ‘act their age’ and slow down but now anymore. People, and my patients, want to continue with their athletic pursuits further as they age and are no longer willing to give it up. Patients want to play tennis, golf, run and compete and as a result they want the same treatment for injuries that younger patients receive.
Too old for ACL surgery
Years ago, orthopedic teaching suggested that there was a cutoff for the surgical repair of ACL ligament tears around the age of 40. As a result, ‘older’ patients were told to live with it and accommodate their lives and activities as needed. Why? At the time it was thought these patients wouldn’t get enough out of their repaired knee. Most in the over 40 crowd had stopped playing soccer and tennis and just wanted to stay fit. Simple jogging, for example, may not require a working ACL.
This teaching seems to have changed. Patients are coming to me in their 50s and 60s with unstable knees asking that I reconstruct their ACL to give them their stability back. I have been impressed with these patients’ ability to work hard on their rehab and reach their goals as easily as the younger patient. This dividing line at 40 has gone away, at least in my practice, and ACL repair is open to all.
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Concerns about arthritis
I often talk about knees being like tires that can wear down over time and eventually wear out. These 50 and 60 year old patients are after further along that path of wear than the younger patient. A part of my discussion with these patients centers around arthritis and developing realistic expectations about how their knee will work in the future. The ACL repair will correct the instability and may slow, but not stop, the progression of arthritis and the pain that can develop from it. A discussion of expectations is very important before starting treatment.
While my experience may be different from other surgeons around the world, I have seen most of my patients return to their sports and athletic pursuits after ACL repair. It’s a great option for athletes of all ages.
If this describes your situation, I would love to hear from you as would my patients ! Please write your comments below !
Dr. Scott Hacker is a Sports Medicine Orthopedic Surgeon in San Diego, CA, Team Surgeon to the US Olympic Team. He specializes in sports medicine and sports injuries, knee and shoulder surgery.