![](https://webarchive.library.unt.edu/eot2008/20081011162829im_/http://www.healthday.com/pics/pixel_dark_blue.gif) ACL Tears Worth Fixing in Seniors
![](https://webarchive.library.unt.edu/eot2008/20081011162829im_/http://www.healthday.com/images/editorial/knee_SS36010.jpg) THURSDAY, March 6 (HealthDay News) -- Baby Boomers are staying active on the basketball court and soccer field, and now new research suggests their injured knees can tolerate surgery just as easily as their younger counterparts.
A new, but small, study found that men and women in their 50s and 60s did well after undergoing reconstruction of injured tissues in their knees known as anterior cruciate ligaments.
A couple decades ago, surgeons wouldn't have bothered to fix these injuries in people over 50, or even 40. Now, "you're never too old to have your ACL reconstructed," said Dr. Diane Dahm, an assistant professor of orthopedic surgery at the Mayo Clinic in Rochester, Minn.
She presented the research Wednesday at the American Academy of Orthopaedic Surgeons' annual meeting, in San Francisco.
The ACL is a kind of anchor that holds the knee together and can become injured when someone is playing sports and tries to turn and pivot, said Dr. Robert Gotlin, director of orthopedic and sports rehabilitation at Beth Israel Medical Center in New York City. Athletes who play sports like football, lacrosse, basketball and soccer are especially prone to the injury, he noted.
Tearing and extreme stretching hurt the ACL. According to Dahm, an injury could come while landing after a rebound on the basketball court. Injuries are also possible off the field, perhaps while changing direction quickly while getting out of a car. Still, she said, most of the injuries are related to sports.
In decades past, surgeons were reluctant to perform procedures on people who had injuries after the age of 40, because it was assumed that "your athletic life is done," Gotlin said. "You don't fix the ACL, because you don't really need it."
Times, and attitudes, have changed.
"Boomers are active, and they're tearing [their ACLs] for the right reasons, because they're working out," he noted. "They're getting hurt, because they're doing more."
As a result, older patients are going under the knife so they can stay active. Gotlin said he's performed surgeries on patients in their 80s who returned to the ski slopes, although rehabilitation can take months.
In the new study, researchers looked at the records of 34 patients who underwent ACL reconstruction surgery between 1990 and 2002 at the Mayo Clinic. All were between the ages of 50 and 66.
The surgery reconstructs the ACL with other tissue, sometimes from the patient's own body.
Eighty-three percent of the patients were considered to have returned to a normal or near-normal state after the surgery, and 83 percent returned to playing sports. However, five of the 34 patients required more knee surgery.
"Some people have felt that it's possible that reconstructing the ACL in these older patients might lead to an increased risk of complications like stiffness in the knee, but our complication rate was very low," Dahm said.
The message, she said, is that the surgery works: "They were able to return to a fairly high level of activity."
More information
Learn more about ACL injuries from the National Institutes of Health.
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![](https://webarchive.library.unt.edu/eot2008/20081011162829im_/http://www.healthday.com/pics/pixel_dark_blue.gif) Life Expectancy Tied to Education
TUESDAY, March 11 (HealthDay News) -- Life expectancy in the United States is on the increase, but only among people with more than 12 years of education, a new study finds.
In fact, those with more than 12 years of education -- more than a high school diploma -- can expect to live to 82; for those with 12 or fewer years of education, life expectancy is 75.
"If you look in recent decades, you will find that life expectancy has been increasing, which is good, but when you split this out by better-educated groups, the life expectancy gained is really occurring much more so in the better-educated groups," said lead researcher Ellen R. Meara, an assistant professor of health care policy at Harvard Medical School.
"The puzzle is why we have been successful in extending life span for some groups. Why haven't we been successful in getting that for less advantaged groups?" Meara said.
The answer may lie with tobacco, the study found.
About one-fifth of the difference in mortality between well-educated and less-educated groups can be accounted for by smoking-related diseases such as lung cancer and emphysema, Meara said.
But the disparity in life expectancy is not only a function of education, Meara said. "Those with less education are likely to have lower income. They're likely to live in areas that have their own health threats, either through crime or poor housing conditions. In addition, they may have worse access to health insurance coverage and health services," she said.
The study was published in the March/April issue of Health Affairs.
For the study, Meara's team collected data on people who took part in the National Longitudinal Mortality Study. The researchers used death certificates, plus estimates from Census data, to create two datasets -- one covering 1981 to 1988 and the other from 1990 to 2000.
The researchers found that in both datasets, life expectancy rose but only for people with more than 12 years of education. For those with 12 years of education or less, life expectancy remained flat through the periods.
When the researchers compared data from the 1980s to data from the 1990s, people with more education had almost a year and half of increased life expectancy. But, for people with less education, life expectancy increased by only six months.
In the period of 1990 to 2000, the better educated saw their life expectancy increase by 1.6 years. For the less educated, life expectancy didn't increase in all.
When the researchers looked at gender differences, they found that less-educated women actually had a decline in life expectancy. In 2000, those women with more than 12 years of education by age 25 could expect to live five years longer than less-educated women, the study found.
The challenge, Meara said, is to figure out ways to extend life expectancy of all groups in U.S society. "We need to get a better understanding of how we can extend these great things we're learning about how to lead healthier lives into these groups," she said.
Dr. David L. Katz, director of the Yale University School of Medicine's Prevention Research Center, thinks fighting poverty and improving education are key to increasing life expectancy among less-advantaged Americans.
"Disparities in health are a major challenge in the United States," he said. "The less affluent and less educated are also, invariably, less healthy."
Initiatives that target health disparities are always welcome, but they may not go far enough if they don't relieve underlying discrepancies in educational or economic status, Katz said.
"Despite efforts throughout the 1980s and 1990s to reduce the disproportionate mortality and morbidity burden experienced by ethnic minorities and the socio-economically disadvantaged, those burdens have persisted," Katz said. "And the gap in life expectancy between the more educated and the less has actually widened."
The take-home message is to redouble efforts to eliminate health disparities, Katz said. "Health is not a product of health care per se, but of one's life course and opportunities. Poverty and limited education are enemies to both opportunity and health. Public health efforts must strive against them as earnestly as against the diseases they drag in their wake."
In another report in the same journal issue, Rachel Kimbro, a sociology professor at Rice University, and colleagues found that immigrants with low levels of education fared better in health outcomes compared with native-born Americans, regardless of race or ethnicity.
The researchers said these differences should be taken into account when targeting programs to reach specific groups of people.
More information
For more on health-care disparities, visit the U.S. Agency for Healthcare Research and Quality.
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![](https://webarchive.library.unt.edu/eot2008/20081011162829im_/http://www.healthday.com/pics/pixel_dark_blue.gif) Yoga Eases Menopause Symptoms in Breast Cancer Survivors
![](https://webarchive.library.unt.edu/eot2008/20081011162829im_/http://www.healthday.com/images/editorial/meditatingwoman.jpg) SATURDAY, March 8 (HealthDay News) -- Yoga helps ease hot flashes and other menopausal symptoms in breast cancer survivors, a U.S. study says.
Some of the 37 women who'd had early stage breast cancer took part in an eight-week "Yoga of Awareness" program, while others were assigned to a control group. All the women self-reported their menopausal symptoms before, immediately after, and three months after the program.
The yoga program used in this study is specifically designed to address menopausal symptoms through gentle stretching postures, breathing exercises, meditation techniques, group discussions and study of yoga principles.
"This program is not what you'd find at your local fitness center," study co-author Laura Porter, an assistant professor of psychiatry and behavioral sciences at Duke University Medical Center, said in a prepared statement. " 'Yoga of Awareness' is based on traditional yoga techniques that go beyond the teaching of specific postures to incorporate practices aimed at reducing stress and creating a heightened sense of awareness and acceptance about one's physical and mental state."
Women who took part in the yoga program showed significant reductions in the frequency and severity of their hot flashes, along with decrease in fatigue, joint pain, sleep disturbance, and symptom-related distress. They also reported increased vigor.
These improvements were still evident three months after the end of the yoga program.
The study was to be presented Saturday at the International Association of Yoga Therapists Symposium for Yoga Therapy and Research, in Los Angeles.
The researchers noted that breast cancer survivors often have more severe menopausal symptoms than other women but have limited treatment options. For example, they can't have hormone replacement therapy that may increase their risk of cancer recurrence. In addition, drugs used to prevent cancer recurrence tend to induce or exacerbate menopausal symptoms.
"While this is a specific pilot program, women seeking similar results could consult with an experienced yoga instructor to learn some of the same techniques," Porter said. "In addition to the traditional yoga postures, a well-trained yoga instructor or other mind-body practitioner may be able to provide instruction in breathing and meditation techniques to help manage stress and alleviate bothersome menopausal symptoms."
More information
The National Institute on Aging has more about menopause .
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