The effect of obesity on complications following isolated posterior cruciate ligament reconstruction

Authors

Anna M. Ifarraguerri, Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, United States. Electronic address: amifarra@gwmail.gwu.edu.
Theodore Quan, Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, United States.
Sophie L. Bernstein, University of Missouri-Kansas City School of Medicine, Kansas City, MO, United States.
Alisa Malyavko, Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, United States.
Casey Gioia, Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, United States.
Alex Gu, Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, United States.
Teresa Doerre, Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, United States.
Matthew J. Best, Department of Orthopaedic Surgery, Johns Hopkins, Columbia, MD, United States.

Document Type

Journal Article

Publication Date

10-1-2022

Journal

The Knee

Volume

38

DOI

10.1016/j.knee.2022.08.007

Keywords

Body mass index; Complications; Obesity; Posterior cruciate ligament; Reconstruction

Abstract

BACKGROUND: This study assessed the risk of 30-day complications for obese patients compared to non-obese patients undergoing isolated posterior cruciate ligament (PCL) reconstruction. METHODS: From 2006 to 2019, the National Surgical Quality Improvement Program database was queried for patients undergoing isolated PCL reconstruction. Two patient cohorts were defined: patients with obesity (BMI ≥ 30.0 kg/m) and patients without obesity (BMI < 30 kg/m). Patients' baseline demographics and medical comorbidities were collected and compared between the cohorts. Postoperative outcomes were assessed using bivariate and multivariate analyses. RESULTS: 414 patients underwent PCL reconstruction. 258 patients (62.3%) were non-obese and 156 patients (37.7%) were obese. Obese patients were more likely to be older, have a higher American Society of Anesthesiologists classification, and have hypertension compared to non-obese patients (p < 0.05 for all). The rates of superficial surgical site infections, wound dehiscence, transfusion necessity, deep vein thrombosis, and re-operation were not significant between obese and non-obese patients. Following adjustment on multivariate analyses, relative to patients without obesity, those with obesity had an increased risk of admission to the hospital overnight (OR 1.66; p = 0.048). CONCLUSIONS: To our knowledge, this is the first study to evaluate obesity on complications in isolated PCL reconstruction. Our results and the heterogeneity in the literature indicate that obesity significantly impacts the rates of hospital readmission for PCL reconstruction. Therefore, surgeons should carefully weigh the risks and benefits of operating on obese patients and plan accordingly as obese patients may require postoperative hospital admission after PCL reconstruction. LEVEL OF EVIDENCE: III.

APA Citation

Ifarraguerri, Anna M.; Quan, Theodore; Bernstein, Sophie L.; Malyavko, Alisa; Gioia, Casey; Gu, Alex; Doerre, Teresa; and Best, Matthew J., "The effect of obesity on complications following isolated posterior cruciate ligament reconstruction" (2022). GW Authored Works. Paper 1854.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/1854

Department

Orthopaedic Surgery