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体重指数在15至30之间并不影响使用直径10毫米的骨-肌腱-骨移植物进行前交叉韧带手术后患者报告的结果。

Body Mass Index Between 15 and 30 Does Not Influence Patient-Reported Outcomes After Anterior Cruciate Ligament Surgery Using a 10-mm-Diameter Bone-Tendon-Bone Graft.

作者信息

Lustig Mia Adler, Hazzard Sean, Fitzgerald Brendan, Stovall Nasir, Asnis Peter

机构信息

Department of Orthopaedic Surgery/Sports Medicine, Massachusetts General Hospital, Waltham, Massachusetts, U.S.A.

Harvard Medical School, Boston, Massachusetts, U.S.A.

出版信息

Arthrosc Sports Med Rehabil. 2024 Mar 19;6(3):100925. doi: 10.1016/j.asmr.2024.100925. eCollection 2024 Jun.

Abstract

PURPOSE

To investigate the relation between body mass index (BMI) and outcomes after anterior cruciate ligament reconstruction (ACLR) using 10-mm-diameter bone-patellar tendon-bone grafts.

METHODS

In this retrospective study, the Surgical Outcome System was used to measure patient-reported outcomes before and after ACLR between 2015 and 2019. The inclusion criteria consisted on patients undergoing primary ACLR performed by the senior surgeon, with recorded age of 15 years or older and BMI of 15.0 to 30. The exclusion criteria included revisions, concomitant procedures, age younger than 15 years, and unknown BMI. Patients were divided into cohorts to evaluate the Marx Activity Rating Scale (MARS), Tegner, International Knee Documentation Committee (IKDC), and Lysholm scores at various time points from injury to 2 years postoperatively.

RESULTS

A total of 137 patients (100 male and 37 female patients) with an average age of 33 years (95% confidence interval, 30.6-35.4 years) and average BMI of 23.58 (95% confidence interval, 23.1-24.0) were divided into those with a BMI of 15 to 23.4 (group A, n = 69) and those with a BMI of 23.5 to 30 (group B, n = 68). A significant difference in MARS scores was found between the BMI groups before treatment, with mean scores of 11.55 (group A) and 9.41 (group B) ( = .011), and Tegner scores showed significance at 2 years, with scores of 6.45 and 5.41 for groups A and B, respectively ( = .009). Daily function scores were all insignificant. Female patients exhibited no significant differences across any patient-reported outcome measures or time points. Contrarily, male patients showed a significant difference in pretreatment MARS scores (14.30 in group A vs 9.96 in group B,  = .011). Additionally, scores at 2 years depicted Tegner values of 7.40 in group A versus 5.30 in group B ( = .012) and IKDC values of 96.92 in group A versus 90.47 in group B ( = .048). All results for female and male patients aged 30 years or younger indicated no significance.

CONCLUSIONS

Regardless of patient age or sex, BMI is not significantly associated with patient-reported outcomes after ACLR using 10-mm-diameter bone-patellar tendon-bone grafts.

LEVEL OF EVIDENCE

Level III, retrospective cohort study.

摘要

目的

探讨采用直径10毫米的骨-髌腱-骨移植物进行前交叉韧带重建(ACLR)后,体重指数(BMI)与手术结果之间的关系。

方法

在这项回顾性研究中,使用手术结果系统来测量2015年至2019年间ACLR手术前后患者报告的结果。纳入标准包括由资深外科医生进行初次ACLR的患者,记录年龄在15岁及以上且BMI为15.0至30。排除标准包括翻修手术、同期手术、年龄小于15岁以及BMI未知。将患者分为不同队列,以评估从受伤到术后2年各个时间点的马克思活动评分量表(MARS)、特格纳评分、国际膝关节文献委员会(IKDC)评分和Lysholm评分。

结果

总共137例患者(100例男性和37例女性),平均年龄33岁(95%置信区间,30.6 - 35.4岁),平均BMI为23.58(95%置信区间,23.1 - 24.0),分为BMI为15至23.4的组(A组,n = 69)和BMI为23.5至30的组(B组,n = 68)。治疗前BMI组之间的MARS评分存在显著差异,A组平均评分为11.55,B组为9.41(P = .011),特格纳评分在术后2年显示出显著性,A组和B组的评分分别为6.45和5.41(P = .009)。日常功能评分均无显著性差异。女性患者在任何患者报告的结果测量或时间点上均无显著差异。相反,男性患者在治疗前MARS评分上存在显著差异(A组为14.30,B组为9.96,P = .011)。此外,术后2年时,A组的特格纳值为7.40,B组为5.30(P = .012),IKDC值A组为96.92,B组为90.47(P = .048)。所有30岁及以下女性和男性患者的结果均无显著性差异。

结论

无论患者年龄或性别如何,使用直径10毫米的骨-髌腱-骨移植物进行ACLR后,BMI与患者报告的结果无显著相关性。

证据水平

III级,回顾性队列研究。

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