Division of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Sports Health. 2020 Jan/Feb;12(1):29-35. doi: 10.1177/1941738119870192. Epub 2019 Sep 5.
Adolescent athletes who sustain an anterior cruciate ligament (ACL) tear have significantly reduced activity levels during recovery. Activity level is linked to body mass index (BMI); however, it is unclear how recovery from an ACL reconstruction (ACLR) affects relative BMI and whether these changes persist after return to activity.
Patients' BMI percentile will significantly increase after ACLR, but will trend toward baseline after return to activity.
Cross-sectional study.
Level 3.
A retrospective review of 666 pediatric and adolescent patients who underwent ACLR was performed. Body mass was assessed by evaluating change in BMI percentile at 8 standard-of-care time windows relative to BMI percentile at time of surgery. Linear regression and bivariate and multivariate analyses were used to assess the effect of time window and other demographic factors on the change in BMI percentile. These analyses were rerun after dividing patients by clinical obesity categorization (underweight, normal, overweight, or obese) at time of surgery to assess the effect of preinjury body mass levels.
BMI percentile of all BMI categories tended to increase postoperatively, peaking 6 to 9 months after surgery, with a median increase of 1.83 percentile points. After this peak, BMI approached baseline but remained elevated at 0.95 percentile points 2 years postoperatively. Beginning 3 months after surgery, the normal-weight group had significantly larger changes in BMI percentile at each time window, peaking at 4.15 points above baseline at 9 months. This BMI increase among normal-weight patients persisted in the second postoperative year, with a median percentile increase of 2.63 points.
Pediatric and adolescent patients, especially those with a normal BMI, undergo significant changes to their BMI during recovery from ACLR.
Patients' failure to return to their presurgical BMI percentile 2 years postoperatively suggests that ACLR may have long-reaching and often unappreciated effects on body mass.
青少年运动员前交叉韧带（ACL）撕裂后，在康复期间活动水平显著降低。活动水平与体重指数（BMI）有关；然而，ACL 重建（ACLR）后恢复情况如何影响相对 BMI ，以及这些变化在恢复活动后是否持续，尚不清楚。
ACL 重建后，患者的 BMI 百分位将显著增加，但在恢复活动后将趋于基线。
横断面研究。
3 级。
对 666 名接受 ACLR 的儿科和青少年患者进行了回顾性研究。通过评估与手术时 BMI 百分位相比，在 8 个标准护理时间窗口时 BMI 百分位的变化来评估体重。线性回归以及双变量和多变量分析用于评估时间窗口和其他人口统计学因素对 BMI 百分位变化的影响。在按手术时临床肥胖分类（体重不足、正常、超重或肥胖）将患者分组后，重新进行这些分析，以评估受伤前体重水平的影响。
所有 BMI 类别的 BMI 百分位均在术后趋于增加，术后 6 至 9 个月达到峰值，中位数增加 1.83 个百分点。在此峰值后，BMI 接近基线水平，但在术后 2 年仍升高 0.95 个百分点。术后 3 个月开始，正常体重组在每个时间窗口的 BMI 百分位变化明显更大，9 个月时比基线高出 4.15 个点。正常体重患者的这种 BMI 增加在术后第二年持续存在，中位数增加 2.63 个百分点。
小儿和青少年患者，尤其是那些正常体重的患者，在 ACLR 康复期间 BMI 会发生显著变化。
患者术后 2 年未能恢复到术前 BMI 百分位，这表明 ACLR 可能对体重产生长期且常常未被认识到的影响。
