Relationship between Body Mass Index and Articular Injuries Accompanying Primary Anterior Cruciate Ligament Tear in Male Knees: A Retrospective Observational Study

Ulusoy, Gökhan Ragıp; Kızılgöz, Volkan; Sivrioğlu, Ali Kemal

doi:10.1055/s-0039-1692668

Cited by 6 publications

(8 citation statements)

References 24 publications

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“…24 . 10, 25 Feucht et al revealed that patients with higher age (p ¼ 0.026) and male gender (p ¼ 0.002) are vulnerable to meniscal tearing in patients with ACL rupture. 5 Ford et al reported that higher BMI is the risk of meniscal tearing.…”

Section: Discussionmentioning

confidence: 99%

Time from Injury Is the Key Predictor of Meniscal Injury in ACL-Deficient Knees

et al. 2021

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The meniscus is one of the most important structures of the knee that needs to be saved if possible. Previous studies showed that increasing time from an anterior cruciate ligament (ACL) injury (TFI) could lead to a meniscal tear, especially medial meniscus (MM). We developed the present study to see if the TFI alone is a predictor of meniscal injury in ACL-deficient knees. We included 111 patients who had a reconstructed ACL injury at our institution from March 2015 to March 2016 in this retrospective cohort study. All demographic data, including age, gender, and body mass index (BMI), were collected. We also recorded the mechanism of injury and the TFI. We extracted the meniscal condition at the time of surgery from the surgical report. All patients were followed up for a mean of 23 months, and the Lysholm score and pain visual analog scale (VAS) score were obtained. The mean TFI of patients with MM tear was 17.4 ± 16.8 months, which was significant than the patients with lateral meniscal (LM) tear (9.3 ± 8.3 months) and intact meniscus (7.4 ± 8.1 months) (p = 0.001). Patients with TFI less than 6 months had a significantly lower rate of MM tear, and increasing TFI more than 6 months could increase the rate of MM tear (p = 0.001). We could not find any association between age, BMI, and gender and meniscal injury. At the latest follow-up, Lysholm and VAS scores in patients with and without meniscal tear were the same. Our study confirms that increasing time from the ACL injury would increase the risk of MM damage. The cutoff point for this risk factor is 6 months from initial injury; therefore, to save the meniscus, it might be better to perform ACL reconstruction within 6 months in ACL-deficient knees.

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Section: Discussionmentioning

confidence: 99%

Time from Injury Is the Key Predictor of Meniscal Injury in ACL-Deficient Knees

et al. 2021

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“…It is known that there could be failure of meniscus repair in patients with a high BMI. 27,[35][36][37] In a study evaluating the all-inside technique, Laurendon et al 27 reported that high BMI was a risk factor for the all-inside technique, and there was a high probability of failure in BHMT repair. These results suggest that there could be suture failure or new tears in the suture site or in different areas of the meniscus in BHMT repair with the all-inside technique in patients with high BMI.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Cases with Anterior Cruciate Ligament Reconstruction Accompanied by Simultaneous Medial Meniscus Bucket Handle Tear Repair and Isolated Medial Meniscus Bucket Handle Tear Repair

et al. 2021

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The aim of this study was to evaluate the success of the all-inside repair technique for medial bucket-handle meniscus tear (BHMT) and the factors affecting healing. A total of 36 patients with BHMT who were operated between 2012 and 2018 and completed final follow-up examinations were included in the study. Functional evaluation was made with the International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner score. Healing was evaluated on magnetic resonance imaging (MRI) slices. The patients were evaluated with respect to the effect on healing of factors such as demographic data, body mass index (BMI), smoking status, anterior cruciate ligament tear reconstruction (ACLTR) applied at the same time as BHMT repair, and the tear being chronic or acute. The mean age of the patients was 28.6 ± 8.6 years (range,18–46 years), the mean follow-up period was 25.8 ± 13.9 months (range, 13–59 months), and BMI was mean 25.6 ± 3.5 kg/m2 (range, 20.1–30.5 kg/m2). The meniscus tears were acute in 16 (44.4%) patients and chronic in 20 (55.6%). ACLTR was applied together with BHMT repair in 25 patients. The hybrid technique, as the outside-in technique in addition to the all-inside technique, was applied to 12 (33.3%) patients, where there was seen to be extension to the anterior horn. The failure rate was determined as 27.8% according to the postoperative MRI evaluation and the Barrett criteria. No positive or negative statistically significant effect on healing was determined of chronic BHMT or of simultaneous application of ACLTR (p = 1.00 and 0.457, respectively). Cigarette smoking and high BMI were determined to have a statistically significant negative effect on healing (p = 0.026 and 0.007, respectively). In conclusion, it can be seen that the success of the all-inside technique for BHMT remains controversial. Due to the features of the application, it can be used in meniscus tears of the posterior horn only. In the current study, with the success rate of 72.2% of the all-inside technique in meniscus body tears, it was seen that a high success rate could not be achieved.

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“…Our study is consistent with those findings, with a higher risk for both medial and lateral chondral injuries with older age. Regarding BMI, Ulusoy et al 43 previously showed a significant relationship between high BMI and articular damage. Conversely, Cristiani et al 28 did not find a significant association with increasing BMI and chondral injury.…”

Section: Discussionmentioning

confidence: 96%

“…Other risk factors have previously been shown to be associated with chondral injury. 29,[39][40][41][42][43][44] Older patients have already been observed to have increased chondral damage and more severe OA changes following ACL injury. 45 Tissue analysis from knee joints has shown that increasing age is linked with biomarkers that are associated with reduced ability for cartilage repair and increased cartilage catabolism.…”

Section: Discussionmentioning

confidence: 99%

Delaying anterior cruciate ligament reconstruction increases the rate and severity of medial chondral injuries

Cance,

Erard,

Shatrov

et al. 2023

Bone Joint J

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AimsThe aim of this study was to evaluate the association between chondral injury and interval from anterior cruciate ligament (ACL) tear to surgical reconstruction (ACLr).MethodsBetween January 2012 and January 2022, 1,840 consecutive ACLrs were performed and included in a single-centre retrospective cohort. Exclusion criteria were partial tears, multiligament knee injuries, prior ipsilateral knee surgery, concomitant unicompartmental knee arthroplasty or high tibial osteotomy, ACL agenesis, and unknown date of tear. A total of 1,317 patients were included in the final analysis, with a median age of 29 years (interquartile range (IQR) 23 to 38). The median preoperative Tegner Activity Score (TAS) was 6 (IQR 6 to 7). Patients were categorized into four groups according to the delay to ACLr: < three months (427; 32%), three to six months (388; 29%), > six to 12 months (248; 19%), and > 12 months (254; 19%). Chondral injury was assessed during arthroscopy using the International Cartilage Regeneration and Joint Preservation Society classification, and its association with delay to ACLr was analyzed using multivariable analysis.ResultsIn the medial compartment, delaying ACLr for more than 12 months was associated with an increased rate (odds ratio (OR) 1.93 (95% confidence interval (CI) 1.27 to 2.95); p = 0.002) and severity (OR 1.23 (95% CI 1.08 to 1.40); p = 0.002) of chondral injuries, compared with < three months, with no association in patients aged > 50 years old. No association was found for shorter delays, but the overall dose-effect analysis was significant for the rate (p = 0.015) and severity (p = 0.026) of medial chondral injuries. Increased TAS was associated with a significantly reduced rate (OR 0.88 (95% CI 0.78 to 0.99); p = 0.036) and severity (OR 0.96 (95% CI 0.92 to 0.99); p = 0.017) of medial chondral injuries. In the lateral compartment, no association was found between delay and chondral injuries.ConclusionDelay was associated with an increased rate and severity of medial chondral injuries in a dose-effect fashion, in particular for delays > 12 months. Younger patients seem to be at higher risk of chondral injury when delaying surgery. The timing of ACLr should be optimally reduced in this population.Cite this article: Bone Joint J 2023;105-B(9):953–960.

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Relationship between Body Mass Index and Articular Injuries Accompanying Primary Anterior Cruciate Ligament Tear in Male Knees: A Retrospective Observational Study

Cited by 6 publications

References 24 publications

Time from Injury Is the Key Predictor of Meniscal Injury in ACL-Deficient Knees

Time from Injury Is the Key Predictor of Meniscal Injury in ACL-Deficient Knees

Comparison of Cases with Anterior Cruciate Ligament Reconstruction Accompanied by Simultaneous Medial Meniscus Bucket Handle Tear Repair and Isolated Medial Meniscus Bucket Handle Tear Repair

Delaying anterior cruciate ligament reconstruction increases the rate and severity of medial chondral injuries

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