Related Experiment Video
Updated: Jul 12, 2025
Author Spotlight: Implementing the Enhanced Recovery After Surgery Concept in Rehabilitation Following Anterior Cruciate Ligament Reconstruction
Published on: March 1, 2024
Increased Body Mass Index is Associated with Worse Mid- To Long-Term Patient Outcomes after Surgical Repair of
Danny Tan1, Stephanie Ferrante1, Alex DiBartola1
1Department of Orthopaedics, Jameson Crane Sports Medicine Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio.
Abstract:
We evaluated the relationship between elevated body mass index (BMI) and mid- to long-term outcomes after surgical treatment of multiligamentous knee injury (MLKI). Records identified patients treated surgically for MLKI at a single institution. Inclusion criteria: minimum 2 years since surgery, complete demographics, surgical data, sustained injuries to two or more ligaments in one or both knees, and available for follow-up. Patients were contacted to complete patient-reported outcomes assessments and were classified according to mechanism of injury. Multivariate logistic regression analysis was used to predict the impact of BMI on outcome scores. A total of 77 patients (72.7% male) were included with a mean age at the time of injury of 29.4 ± 11.0 years and a mean BMI of 30.5 ± 9.4 kg/m2. The mean length of follow-up was 7.4 years. For each 10 kg/m2 increase in BMI, there is a 0.9-point decrease in Tegner activity scale (p = 0.001), a 5-point decrease in Knee Injury and Osteoarthritis Outcome Score (KOOS)-pain (p = 0.007), a 5-point decrease in KOOS-ADL (p = 0.003), a 10-point decrease in KOOS-QOL (p = 0.002), and an 11-point decrease in KOOS-Sport (p = 0.002). There were no significant correlations with BMI and Pain Catastrophizing Scale or Patient Health Questionnaire scores. Increasing BMI has a negative linear relationship with mid- to long-term clinical outcomes including pain, ability to perform activities of daily living, quality of life, and ability to perform more demanding physical activity after MLKI. BMI does not appear to have a significant relationship with knee swelling and mechanical symptoms or patients' mental health.
Insights
Elevated body mass index (BMI) negatively impacts long-term outcomes after knee ligament surgery. Higher BMI correlates with reduced activity, increased pain, and lower quality of life following multiligamentous knee injury (MLKI) treatment.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Biostatistics
Background:
- Multiligamentous knee injury (MLKI) requires surgical intervention, with outcomes potentially influenced by patient factors.
- Elevated body mass index (BMI) is a common comorbidity that may affect surgical outcomes.
Purpose of the Study:
- To investigate the association between elevated body mass index (BMI) and mid- to long-term clinical outcomes after surgical treatment for multiligamentous knee injury (MLKI).
Main Methods:
- Retrospective review of patients undergoing MLKI surgery with a minimum 2-year follow-up.
- Patient-reported outcome measures (PROMs) including Tegner activity scale and Knee Injury and Osteoarthritis Outcome Score (KOOS) were collected.
- Multivariate logistic regression analysis assessed the impact of BMI on outcome scores.
Main Results:
- Higher BMI demonstrated a negative linear relationship with key functional outcomes.
- Each 10 kg/m² increase in BMI correlated with decreased Tegner activity, KOOS-pain, KOOS-ADL, KOOS-QOL, and KOOS-Sport scores.
- No significant correlation was found between BMI and pain catastrophizing or mental health scores.
Conclusions:
- Elevated BMI is associated with poorer mid- to long-term functional outcomes and quality of life following MLKI surgery.
- BMI does not appear to significantly affect knee swelling, mechanical symptoms, or mental health in this patient cohort.
- These findings highlight the importance of considering BMI in the management and rehabilitation of patients with MLKI.
