Articular cartilage damage in the patellofemoral compartment at ACL reconstruction predicts poor postoperative subjective outcomes in patients age 40 and older

The purpose of this study was to investigate factors that influence clinical outcomes after ACL reconstruction in patients age 40 and older. We studied 264 patients aged 40 or older and 154 patients aged 20 or younger who underwent ACL reconstruction at several surgical centers. Logistic regression analysis was conducted to identify factors that influenced the KOOS scores at 1 year post ACL reconstruction. In the older patient group, cartilage damage in the patellofemoral compartment at surgery was a significant risk factor for poor postoperative KOOS subscores (pain, ADL, sports, and QOL). Articular cartilage damage in the lateral compartment also significantly influenced one of the postoperative KOOS subscores (symptoms). In the younger patient group, articular cartilage damage in any compartments did not influenced the postoperative KOOS subscores; only two preoperative KOOS subscores (symptoms and QOL) significantly influenced their postoperative KOOS subscores. We concluded that the articular cartilage damage in the patellofemoral compartment at ACL reconstruction predicts poor KOOS subscores at one year follow-up in patients age 40 or older.

Publication History

Received: 04 July 2023

Accepted after revision: 16 July 2024

Accepted Manuscript online:
17 July 2024