Editorial Commentary: Age-Appropriate Expectations Are Critical When Analyzing Knee Anterior Cruciate Ligament Reconstruction Outcomes: Age Is More Than Just a Number

Editorial Commentary: Personalized Anterior Cruciate Ligament Reconstruction and Rehabilitation Mitigate Postoperative Arthrofibrosis: Prevention Is the Best Approach

Arthrofibrosis after anterior cruciate ligament reconstruction can become a major complication requiring surgical intervention. The reported incidence approximates 8% but varies widely (2%-35%) and, as not all patients require surgery, may be underreported. Several risk factors are involved. Female sex, older age, surgery within the first month after injury, and meniscus repair are consistently associated with increased risk. Other factors include graft size and type, concomitant procedures, use of anticoagulants, and genetic factors. By identifying risk factors, we can modify our surgical technique and rehabilitation to meet each patient's needs with fewer complications.

Editorial Commentary: Outcome Thresholds for Minimally Clinically Important Difference and Patent Acceptable Symptomatic State Must Be Adjusted for Age in Patients Having Anterior Cruciate Ligament Reconstruction

Current evidence suggests that performing anterior cruciate ligament reconstruction in the older patient population yields acceptable results both subjectively as well as objectively when compared with a much-younger demographic. It is no surprise that reconstructing the anterior cruciate ligament will result in objectively decreased knee laxity as well as decreased subjective joint instability, but when everything is said and done, patient satisfaction is what really matters. Therefore, achieving the patent acceptable symptomatic state is more important than a "minimal" clinically important difference, particularly as nonsurgical treatment is sometimes an alternative. Moreover, these thresholds must be adjusted so as to be age appropriate to be clinically useful. Alternatively, a simple, patient-reported Single Assessment Numerical Evaluation rating would adjust for age discrepancies, as would asking an anchor question, such as "are you satisfied?"