Weak associations between body mass index and self-reported disability in people with unilateral anterior cruciate ligament reconstruction

Brian Pietrosimone, Christopher Kuenze, Joseph M. Hart, Charles Thigpen, Adam S. Lepley, J. Troy Blackburn, Darin A. Padua, Terry L. Grindstaff, Hope Davis, David Bell

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose and hypothesis: Individuals with an anterior cruciate ligament reconstruction (ACLR) are susceptible to persistent disability, weight gain and the development of knee osteoarthritis. It remains unclear whether body mass index (BMI) is a factor that influences disability following ACLR. The purpose of this study was to determine the association between BMI and self-reported disability [International Knee Documentation Committee (IKDC) Index] in individuals with a unilateral ACLR. We hypothesized that lower BMI would associate with higher IKDC. Methods: BMI and IKDC were measured in 668 individuals with a unilateral ACLR (60.9% female, BMI 24.4 ± 3.7 kg/m2, IKDC 84.7 ± 11.9%). Bivariate associations were conducted between BMI and IKDC for the entire sample and selected subsets (gender, ACLR graft type and history of meniscal injury). Multiple regression analyses were used to determine the impact of potential covariates (Tegner score, age and months since ACLR) for significant bivariate associations. After accounting for covariates, there were no significant associations between BMI and IKDC when separately evaluating the cohort based on either gender or history of a concomitant meniscal injury. The odds of achieving age- and gender-matched healthy population average IKDC scores for those with low (<25) and high (≥25) BMI were determined. Results: Lower BMI associated with higher IKDC (r = −0.08, P = 0.04). For the entire sample, BMI did not uniquely predict variance in IKDC (ΔR2 > 0.001, n.s.) after accounting for covariates. BMI uniquely predicted a significant but negligible amount of variance in IKDC in individuals with a patellar tendon autograft (ΔR2 = 0.015, n.s.). Individuals with low BMI demonstrated higher odds (odds ratio = 1.45; 1.05–1.99) of achieving population average IKDC scores compared to participants with high BMI. Conclusions: There was a significant but negligible correlation between lower BMI and lesser disability in individuals with unilateral ACLR and individuals who are underweight or of normal BMI demonstrated higher odds of achieving population average IKDC scores compared to overweight or obese individuals. While an overall association was found between lower BMI and lesser disability, the magnitude of the association remains negligible; therefore, BMI was not a strong clinical predictor of successful ACLR outcomes in this cohort of patients with unilateral ACLR. Level of evidence: Cross-sectional prognostic study, Level II.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalKnee Surgery, Sports Traumatology, Arthroscopy
DOIs
StateAccepted/In press - Aug 28 2017

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Anterior Cruciate Ligament Reconstruction
Disabled Persons
Body Mass Index
Documentation
Knee
Population
Patellar Ligament
Thinness
Knee Osteoarthritis
Autografts
Wounds and Injuries
Weight Gain

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Weak associations between body mass index and self-reported disability in people with unilateral anterior cruciate ligament reconstruction. / Pietrosimone, Brian; Kuenze, Christopher; Hart, Joseph M.; Thigpen, Charles; Lepley, Adam S.; Blackburn, J. Troy; Padua, Darin A.; Grindstaff, Terry L.; Davis, Hope; Bell, David.

In: Knee Surgery, Sports Traumatology, Arthroscopy, 28.08.2017, p. 1-9.

Research output: Contribution to journalArticle

Pietrosimone, Brian ; Kuenze, Christopher ; Hart, Joseph M. ; Thigpen, Charles ; Lepley, Adam S. ; Blackburn, J. Troy ; Padua, Darin A. ; Grindstaff, Terry L. ; Davis, Hope ; Bell, David. / Weak associations between body mass index and self-reported disability in people with unilateral anterior cruciate ligament reconstruction. In: Knee Surgery, Sports Traumatology, Arthroscopy. 2017 ; pp. 1-9.
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abstract = "Purpose and hypothesis: Individuals with an anterior cruciate ligament reconstruction (ACLR) are susceptible to persistent disability, weight gain and the development of knee osteoarthritis. It remains unclear whether body mass index (BMI) is a factor that influences disability following ACLR. The purpose of this study was to determine the association between BMI and self-reported disability [International Knee Documentation Committee (IKDC) Index] in individuals with a unilateral ACLR. We hypothesized that lower BMI would associate with higher IKDC. Methods: BMI and IKDC were measured in 668 individuals with a unilateral ACLR (60.9{\%} female, BMI 24.4 ± 3.7 kg/m2, IKDC 84.7 ± 11.9{\%}). Bivariate associations were conducted between BMI and IKDC for the entire sample and selected subsets (gender, ACLR graft type and history of meniscal injury). Multiple regression analyses were used to determine the impact of potential covariates (Tegner score, age and months since ACLR) for significant bivariate associations. After accounting for covariates, there were no significant associations between BMI and IKDC when separately evaluating the cohort based on either gender or history of a concomitant meniscal injury. The odds of achieving age- and gender-matched healthy population average IKDC scores for those with low (<25) and high (≥25) BMI were determined. Results: Lower BMI associated with higher IKDC (r = −0.08, P = 0.04). For the entire sample, BMI did not uniquely predict variance in IKDC (ΔR2 > 0.001, n.s.) after accounting for covariates. BMI uniquely predicted a significant but negligible amount of variance in IKDC in individuals with a patellar tendon autograft (ΔR2 = 0.015, n.s.). Individuals with low BMI demonstrated higher odds (odds ratio = 1.45; 1.05–1.99) of achieving population average IKDC scores compared to participants with high BMI. Conclusions: There was a significant but negligible correlation between lower BMI and lesser disability in individuals with unilateral ACLR and individuals who are underweight or of normal BMI demonstrated higher odds of achieving population average IKDC scores compared to overweight or obese individuals. While an overall association was found between lower BMI and lesser disability, the magnitude of the association remains negligible; therefore, BMI was not a strong clinical predictor of successful ACLR outcomes in this cohort of patients with unilateral ACLR. Level of evidence: Cross-sectional prognostic study, Level II.",
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AU - Pietrosimone, Brian

AU - Kuenze, Christopher

AU - Hart, Joseph M.

AU - Thigpen, Charles

AU - Lepley, Adam S.

AU - Blackburn, J. Troy

AU - Padua, Darin A.

AU - Grindstaff, Terry L.

AU - Davis, Hope

AU - Bell, David

PY - 2017/8/28

Y1 - 2017/8/28

N2 - Purpose and hypothesis: Individuals with an anterior cruciate ligament reconstruction (ACLR) are susceptible to persistent disability, weight gain and the development of knee osteoarthritis. It remains unclear whether body mass index (BMI) is a factor that influences disability following ACLR. The purpose of this study was to determine the association between BMI and self-reported disability [International Knee Documentation Committee (IKDC) Index] in individuals with a unilateral ACLR. We hypothesized that lower BMI would associate with higher IKDC. Methods: BMI and IKDC were measured in 668 individuals with a unilateral ACLR (60.9% female, BMI 24.4 ± 3.7 kg/m2, IKDC 84.7 ± 11.9%). Bivariate associations were conducted between BMI and IKDC for the entire sample and selected subsets (gender, ACLR graft type and history of meniscal injury). Multiple regression analyses were used to determine the impact of potential covariates (Tegner score, age and months since ACLR) for significant bivariate associations. After accounting for covariates, there were no significant associations between BMI and IKDC when separately evaluating the cohort based on either gender or history of a concomitant meniscal injury. The odds of achieving age- and gender-matched healthy population average IKDC scores for those with low (<25) and high (≥25) BMI were determined. Results: Lower BMI associated with higher IKDC (r = −0.08, P = 0.04). For the entire sample, BMI did not uniquely predict variance in IKDC (ΔR2 > 0.001, n.s.) after accounting for covariates. BMI uniquely predicted a significant but negligible amount of variance in IKDC in individuals with a patellar tendon autograft (ΔR2 = 0.015, n.s.). Individuals with low BMI demonstrated higher odds (odds ratio = 1.45; 1.05–1.99) of achieving population average IKDC scores compared to participants with high BMI. Conclusions: There was a significant but negligible correlation between lower BMI and lesser disability in individuals with unilateral ACLR and individuals who are underweight or of normal BMI demonstrated higher odds of achieving population average IKDC scores compared to overweight or obese individuals. While an overall association was found between lower BMI and lesser disability, the magnitude of the association remains negligible; therefore, BMI was not a strong clinical predictor of successful ACLR outcomes in this cohort of patients with unilateral ACLR. Level of evidence: Cross-sectional prognostic study, Level II.

AB - Purpose and hypothesis: Individuals with an anterior cruciate ligament reconstruction (ACLR) are susceptible to persistent disability, weight gain and the development of knee osteoarthritis. It remains unclear whether body mass index (BMI) is a factor that influences disability following ACLR. The purpose of this study was to determine the association between BMI and self-reported disability [International Knee Documentation Committee (IKDC) Index] in individuals with a unilateral ACLR. We hypothesized that lower BMI would associate with higher IKDC. Methods: BMI and IKDC were measured in 668 individuals with a unilateral ACLR (60.9% female, BMI 24.4 ± 3.7 kg/m2, IKDC 84.7 ± 11.9%). Bivariate associations were conducted between BMI and IKDC for the entire sample and selected subsets (gender, ACLR graft type and history of meniscal injury). Multiple regression analyses were used to determine the impact of potential covariates (Tegner score, age and months since ACLR) for significant bivariate associations. After accounting for covariates, there were no significant associations between BMI and IKDC when separately evaluating the cohort based on either gender or history of a concomitant meniscal injury. The odds of achieving age- and gender-matched healthy population average IKDC scores for those with low (<25) and high (≥25) BMI were determined. Results: Lower BMI associated with higher IKDC (r = −0.08, P = 0.04). For the entire sample, BMI did not uniquely predict variance in IKDC (ΔR2 > 0.001, n.s.) after accounting for covariates. BMI uniquely predicted a significant but negligible amount of variance in IKDC in individuals with a patellar tendon autograft (ΔR2 = 0.015, n.s.). Individuals with low BMI demonstrated higher odds (odds ratio = 1.45; 1.05–1.99) of achieving population average IKDC scores compared to participants with high BMI. Conclusions: There was a significant but negligible correlation between lower BMI and lesser disability in individuals with unilateral ACLR and individuals who are underweight or of normal BMI demonstrated higher odds of achieving population average IKDC scores compared to overweight or obese individuals. While an overall association was found between lower BMI and lesser disability, the magnitude of the association remains negligible; therefore, BMI was not a strong clinical predictor of successful ACLR outcomes in this cohort of patients with unilateral ACLR. Level of evidence: Cross-sectional prognostic study, Level II.

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