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Background: Results of anterior cruciate ligament (ACL) reconstruction are traditionally excellent in younger and nonarthritic patients. During the past few decades, people older than 60 years have become more active than ever, with more demanding physical lifestyles. An increase also has been noted in active patients with diagnosed ACL injuries. More patients are requesting treatment for ACL deficiency in hopes of returning to preinjury levels of activity. Purpose: The aims of this study were to evaluate the results of ACL reconstruction in patients older than 60 years in terms of functional recovery, return to sports, and postoperative incidence of osteoarthritis and to compare their results with published results of different age groups. Study Design: Case series; Level of evidence, 4. Methods: Consecutive patients older than 60 years with isolated ACL tear and no established osteoarthritic lesions (Ahlbäck grade 1 or no arthritis) who were treated from 2008 to 2013 were retrospectively included in this study. Primary ACL reconstruction was performed with the same technique in all patients by means of single-bundle autologous hamstring tendon graft. Meniscal injuries were treated with partial debridement when required. No further treatment on cartilage lesions was performed. Postoperative rehabilitation was the same in every case. The International Knee Documentation Committee (IKDC) objective grade, Lysholm score, and Knee injury and Osteoarthritis Outcome Score (KOOS) were assessed before and after surgery, and the Anterior Cruciate Ligament–Return to Sport after Injury (ACL-RSI) score was recorded during the final follow-up. Postoperative incidence of osteoarthritis was evaluated on weightbearing radiographs during final follow-up, and anteroposterior laxity was measured pre- and postoperatively with the use of stress radiographs. Results: Twelve patients with mean age (±SD) of 61.0 ± 1.4 years at the time of surgery were included. They were followed-up for a mean period of 49.6 ± 24.0 months. Eight patients had associated meniscal tears, and 6 patients had International Cartilage Repair Society stage 1 or 2 chondral lesions. Preoperatively, the objective IKDC grades were B in 4 patients, C in 5, and D in 3. After surgery, the IKDC grades were A in 4 patients, B in 7, and grade C in 1. The mean subjective IKDC and Lysholm scores were a respective 43.4 ± 8.4 and 55.7 ± 12.4 preoperatively and 83.8 ± 9.4 and 93.2 ± 9.0 at the final follow-up (P < .05). Ten patients (83%) reported recovery of sports activities, with 6 patients (50%) reaching the same level as before injury. The mean ACL-RSI score was 76.2%. Preoperatively, 50% (n = 6) of patients had Ahlbäck stage 1 medial compartment arthritis, versus 58% (n = 7) at the final follow-up (P = nonsignificant). The side-to-side difference in anterior tibial translation on stress radiographs was 7.2 ± 6.4 mm preoperatively and 1.9 ± 4.3 mm postoperatively (P < .05). No major complications were reported. Conclusion: ACL reconstruction in active patients older than 60 years without arthritis restored knee stability in all treated cases. In these patients, as in younger age groups, ACL reconstruction showed good results on functional recovery while not increasing the risk of midterm functional knee deterioration or evolution of knee arthritis. The majority of patients returned to activities at their preinjury level. These data show that older and active patients with nonarthritic ACL-deficient knees need not be excluded from surgical treatment. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To assess prior cervical cancer screening, stage at time of diagnosis and outcome in women sixty years of age and over with cervical cancer. Methods: A retrospective review of cervical cancer patients evaluated at the University of Washington identified a cohort of women age sixty and older with cervical cancer diagnosed between January 1, 1993 and December 31, 2003. Electronic medical records and the University of Washington Tumor Registry were reviewed for age, ethnicity, cervical cancer risk factors, pathology, treatment, and outcome. Results: Six hundred forty-five women with cervical cancer were identified. One hundred (15.5%) women were age 60 or older with a median age of 64 years. At time of diagnosis, 41 were early stage (1A1–1B1) and 59 were advanced stage (1B2–4B). Length of time from last Pap smear significantly correlated with stage. Radical hysterectomy was performed on 29 patients, and 15 received adjuvant treatment. Forty-nine women received primary chemo-radiation, and 22 were treated with primary radiation. Lymph node metastases were identified in 65% of women with locally advanced cervical cancer. At conclusion of the study period, 80% were alive. Stage and time since last Pap smear correlated with overall outcome. Conclusions: Women 60 and older make up a significant proportion of cervical cancer patients, often fail to receive screening, present with locally advanced disease, and tolerate standard treatment protocols. Careful consideration of these findings should be made when establishing Pap smear screening guidelines for this population of women. [Copyright &y& Elsevier]