Gibbs David, Flanigan David C, Mallory Noah, Qin Charles, Milliron Eric M, Cavendish Parker A, Gonzalez Roberto, Kirven James, Kaeding Christopher C, Magnussen Robert A
The Ohio State University College of Medicine, Columbus, Ohio, USA.
OSU Sports Medicine Research Institute, The Ohio State University, Columbus, Ohio, USA.
Orthop J Sports Med. 2025 May 20;13(5):23259671251331140. doi: 10.1177/23259671251331140. eCollection 2025 May.
The effect of body mass index (BMI) on complication risk, recurrent instability risk, and patient-reported outcomes (PROs) after surgical intervention for recurrent patellar instability is unclear.
PURPOSE/HYPOTHESIS: The purpose was to evaluate the differences in complications, recurrence, and PROs in obese and nonobese patients undergoing isolated medial patellofemoral ligament reconstruction (MPFLR). It was hypothesized that obesity is associated with increased complication risk, increased risk of recurrent patellar instability, and poorer PROs after MPFLR.
Cohort study; Level of evidence, 3.
A retrospective review identified all patients who underwent isolated MPFLR over an 8.5-year period at an academic medical center. Records were reviewed for demographic, physical examination, radiographic, surgical, and clinical outcome data. Patients were contacted to collect PROs, including the Norwich Patellar Instability score, Marx activity scale score, and Knee injury and Osteoarthritis Outcome Score (KOOS). Patients were stratified by BMI (<30 and ≥30 kg/m for primary analysis and then by ≥35 kg/m for secondary analysis) and complications and outcomes were compared. Regression analysis was then performed to evaluate the effects of increased BMI on PROs.
The records of 107 patients were analyzed in this investigation. Complication rates were similar across groups. Patients with a BMI ≥35 kg/m demonstrated a lower Marx activity scale score compared with those with a BMI <30 kg/m ( = .039). Regression analysis demonstrated no association between BMI and PROs adjusting for age, sex, and articular cartilage damage.
No significant differences in complications or repeat dislocation risk after isolated MPFLR were noted based on BMI ≥30 or <30 kg/m. Patients with a BMI ≥35 kg/m demonstrated lower activity level, but no other differences in PROs compared with patients with a BMI <30 kg/m.
体重指数（BMI）对复发性髌骨不稳定手术干预后并发症风险、复发性不稳定风险及患者报告结局（PROs）的影响尚不清楚。
目的/假设：目的是评估接受单纯内侧髌股韧带重建术（MPFLR）的肥胖和非肥胖患者在并发症、复发情况及PROs方面的差异。假设肥胖与MPFLR术后并发症风险增加、髌骨复发性不稳定风险增加及PROs较差相关。
队列研究；证据等级，3级。
一项回顾性研究确定了在一家学术医疗中心8.5年期间接受单纯MPFLR的所有患者。查阅记录以获取人口统计学、体格检查、影像学、手术及临床结局数据。联系患者收集PROs，包括诺维奇髌骨不稳定评分、马克思活动量表评分及膝关节损伤和骨关节炎结局评分（KOOS）。患者按BMI分层（<30和≥30 kg/m²用于初步分析，然后按≥35 kg/m²用于二次分析），并比较并发症和结局。然后进行回归分析以评估BMI增加对PROs的影响。
本研究分析了107例患者的记录。各组并发症发生率相似。BMI≥35 kg/m²的患者与BMI<30 kg/m²的患者相比，马克思活动量表评分较低（P = 0.039）。回归分析显示，在调整年龄、性别和关节软骨损伤后，BMI与PROs之间无关联。
基于BMI≥30或<30 kg/m²，单纯MPFLR术后并发症或再次脱位风险无显著差异。BMI≥35 kg/m²的患者与BMI<30 kg/m²的患者相比，活动水平较低，但在PROs方面无其他差异。
