Meeting NewsPerspective

Medial patellofemoral ligament reconstruction seen as safe, effective in patients with high BMI

Seth Sherman headshot
Seth L. Sherman

ORLANDO — Results presented at the Arthroscopy Association of North America Annual Meeting showed medial patellofemoral ligament reconstruction was safe and effective in patients with a BMI of greater than 30 kg/m2.

Seth L. Sherman, MD, and colleagues collected the preoperative and postoperative patient-reported outcomes, specifically KOOS and Tegner scores, of 55 patients with recurrent patella instability who underwent medial patellofemoral ligament reconstruction. Researchers compared outcomes of patients with a BMI of less than 30 kg/m2 to those of patients with a BMI of greater than 30 kg/m2.

“Complications requiring reoperation were recorded, including infection, stiffness and recurrent instability,” Sherman said in his presentation here.

Sherman noted improvements in all KOOS domains among patients with a BMI of less than 30 kg/m2 and those with a BMI of greater than 30 kg/m2. However, patients with a BMI of greater than 30 kg/m2 had inferior quality of life scores compared with patients who had a BMI of less than 30 kg/m2, according to Sherman. He added patients with a BMI of less than 30 kg/m2 also had superior Tegner outcomes.

“Complications were low and comparable between groups,” Sherman said. “There were no statistically significant differences and a low number of complications overall.” – by Casey Tingle

 

Reference:

Sherman SL, et al. The influence of BMI greater than 30 on outcomes and complications following medial patellofemoral ligament reconstruction. Presented at: Arthroscopy Association of North America Annual Meeting; May 2-4, 2019; Orlando.

 

Disclosure: Sherman reports no relevant financial disclosures.

Seth Sherman headshot
Seth L. Sherman

ORLANDO — Results presented at the Arthroscopy Association of North America Annual Meeting showed medial patellofemoral ligament reconstruction was safe and effective in patients with a BMI of greater than 30 kg/m2.

Seth L. Sherman, MD, and colleagues collected the preoperative and postoperative patient-reported outcomes, specifically KOOS and Tegner scores, of 55 patients with recurrent patella instability who underwent medial patellofemoral ligament reconstruction. Researchers compared outcomes of patients with a BMI of less than 30 kg/m2 to those of patients with a BMI of greater than 30 kg/m2.

“Complications requiring reoperation were recorded, including infection, stiffness and recurrent instability,” Sherman said in his presentation here.

Sherman noted improvements in all KOOS domains among patients with a BMI of less than 30 kg/m2 and those with a BMI of greater than 30 kg/m2. However, patients with a BMI of greater than 30 kg/m2 had inferior quality of life scores compared with patients who had a BMI of less than 30 kg/m2, according to Sherman. He added patients with a BMI of less than 30 kg/m2 also had superior Tegner outcomes.

“Complications were low and comparable between groups,” Sherman said. “There were no statistically significant differences and a low number of complications overall.” – by Casey Tingle

 

Reference:

Sherman SL, et al. The influence of BMI greater than 30 on outcomes and complications following medial patellofemoral ligament reconstruction. Presented at: Arthroscopy Association of North America Annual Meeting; May 2-4, 2019; Orlando.

 

Disclosure: Sherman reports no relevant financial disclosures.

    Perspective
    Miho J. Tanaka

    Miho J. Tanaka

    In their study, Sherman and colleagues compared outcomes between non-obese and obese patients undergoing medial patellofemoral ligament (MPFL) reconstruction for the treatment of patellar instability. The authors reported on 57 knees who underwent MPFL reconstruction, of which 26 had BMI of greater than 30 kg/m2 (mean age 28.3 years) and 31 knees had BMI of less than 30 kg/m2 (mean age 25 years).

    At minimum 6-month follow-up (range 6 to 59.3 months), patients with BMI of greater than 30 kg/m2 had significantly improved scores in KOOS pain, ADL, symptoms and sports/recreation, but reported lower KOOS quality of life scores (33.34 +/-19.10 vs. 54.47 +/-28, P=.03) and Tegner scores (2.56 +/-1.59 vs. 4.78 +/-2.68, P =.05) than the less than 30 kg/m2 group. Overall, the authors reported that complication rates were low and not significantly different between the two groups.

    While outcomes after MPFL reconstruction can be dependent on a number of variables including anatomical and technique-related factors, this study is one of the first to address the patient-related factor of BMI in this procedure. While larger and longer-term series may help clarify whether this differential persists over time or correlates with other anatomical factors, this study highlights the importance of considering BMI in our efforts to stratify risk and manage patient expectations in the treatment of patellar instability.

    • Miho J. Tanaka, MD
    • Associate professor
      Department of orthopedic surgery
      Director, Women’s Sports Medicine Program
      The Johns Hopkins Hospital
      Baltimore

    Disclosures: Tanka reports no relevant financial disclosures.

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