Associations of body mass index with meniscal tears.
ABSTRACT Meniscal tears are common knee injuries, with limited reported data on associated factors, let alone risk factors. The objective of this study was to determine whether associations exist between increasing obesity and meniscal tears leading to surgery.
We performed frequency-matched case-control studies using surgical case data for years 1996 to 2000 from administrative databases of two large Utah hospitals; each case was matched with three controls from a large cancer screening trial. Meniscal tear cases (262 male and 282 female) were determined by surgical procedures. Inclusion criteria were age (50 to 79) and body mass index (BMI) (17.00 to 54.99 kg/m(2)). Gender-specific, age-adjusted odds ratios with 95% confidence intervals (CIs) were calculated for BMI categories from <20.00 to >/=40.00. The referent BMI category was 20.00 to 22.49.
Age-adjusted odds ratios for likelihood of meniscal surgery among those with a BMI of >/=40.00 were 15.0 (95% CI=3.8-59.0) for men, and 25.1 (95% CI=10.3-60.8) for women. All odds ratios for men and women with BMIs of >/=27.50 and >/=25.00, respectively, were statistically significantly elevated.
Significant associations were demonstrated between increasing BMI and meniscal surgeries in both genders, including obese and overweight adults.
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ABSTRACT: Objective: Higher body mass index (BMI) increases the risk of meniscus injury and knee osteoarthritis (OA). However, it is unknown if and how obesity affects meniscus biology. We analyzed transcriptome-wide gene expression profiles of injured human menisci to test the hypothesis that meniscal gene expression signatures relate to patient BMI. Methods: Meniscus samples were collected from patients undergoing arthroscopic partial meniscectomy. Transcriptome-wide analysis of gene expression followed by validation of selected transcripts by QuantiGene Plex assay was performed. Correlations of gene expression with BMI and relative fold-changes in three BMI categories [lean (LN; BMI=18.5-24.9 kg/m(2) ), overweight (OW; BMI=25.0-29.9 kg/m(2) ), obese (OB; BMI>30.0 kg/m(2) )] were analyzed and integrated functional classifications were probed computationally. Results: OB/OW comparison resulted in the largest set of differences (565-transcripts) followed by OB/LN (280-transcripts) and OW/LN (125-transcripts) comparisons. Biologic reproducibility was confirmed by cluster analysis of expressed transcripts. Differentially regulated transcripts represented important functional classifications. Transcripts associated with oxygen-transport, calcium-ion-binding, and cell-homeostasis were elevated with BMI while those related to extracellular-matrix-deposition, cell-migration, and glucosamine-metabolic-processes were repressed. While these functional classifications may play key roles in cartilage/meniscus homeostasis, failure of extracellular-matrix-deposition and increase in calcium-ion-binding likely contribute to OA development following meniscal injury. Conclusion: Our results indicate greater differences in gene expression between OB/OW category rather than OW/LN category. This may indicate that there is a weight-threshold at which injured meniscus responds severely to increased BMI. BMI-related changes in gene expression present a plausible explanation for the role of meniscal injury in OA development among obese patients. © 2014 American College of Rheumatology.08/2014; 66(8). DOI:10.1002/art.38643
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ABSTRACT: To provide guidance in the selection of the appropriate patient for arthroscopic debridement. Ninety patients who were diagnosed with gonarthrosis according to modified American College of Rheumatology (ACR) criteria and who underwent arthroscopic debridement and meniscectomy were evaluated. Functional assessment of patients was made based on preoperative as well as 1 month and 1 year postoperative results of the Lysholm Knee Score and the Visual Analog Scale (VAS). One year postoperatively, the Tapper-Hoover Scoring System was used to calculate long-term results. Analyses were conducted using SPSS 18 software. For this study ethics committee approval was received from the ethics committee of Ataturk University Medical Studies Department Head on 08.10.2010 at the 6th meeting with regards to the document written on 16.06.2010 with number 998. Differences between preoperative and 1-month and 1-year postoperative values in the Western Otorino and McMaster Universities Osteoarthrosis (WOMAC) Index, Lysholm and VAS were found to be statistically significant (p<0.001) (Table 1). According to Tapper-Hoover results, 82.8% of patients benefited from arthroscopic debridement in the long term (Table 2). Among body mass index (BMI) groups, the WOMAC, Lysholm and VAS values of obese patients were worse than those of normal weight and underweight patients, and the difference was statistically significant (p<0.005). Late-term results of patients younger than 55 were superior to those over 55. In the treatment of patients with gonarthrosis, arthroscopic debridement is a good option. Patients who have a low BMI and are younger than 55 years old experience more benefit from arthroscopic debridement.
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ABSTRACT: Obesity is highly prevalent among patients with knee and shoulder injuries and is associated with greater odds of surgical treatment for these injuries. The purpose of this systematic review was to summarize the literature that has examined the association between body mass index (BMI) and outcomes of ambulatory knee and shoulder surgery. A literature search of PubMed and Medline was conducted up to December 2013. Studies that examined the association between BMI and outcomes after ambulatory knee and shoulder surgery (arthroscopy, repairs, and reconstructions) were included. Outcomes included postoperative functional scores, clinical scores, and complications. Eighteen studies were included in this review; 13 involved knee surgery and 5 involved shoulder surgery. Seven knee studies and 2 shoulder studies found increased BMI to be associated with worse postoperative outcomes, whereas the remaining 9 studies did not find an association. Increased BMI was associated with worse clinical scores and less patient satisfaction after arthroscopic meniscectomy or debridement, and with worse clinical scores and lower activity levels after anterior cruciate ligament (ACL) reconstruction. It was also associated with worse clinical scores and a longer hospital stay after rotator cuff repair and with longer time to return to work after subacromial decompression. Six studies examined the association between BMI and complications, but all reported null findings. There is a lack of consensus in the literature regarding the association between BMI and ambulatory knee and shoulder surgery. Several factors may have contributed to contradictory findings, including variation in measuring and classifying anthropometry, postoperative outcomes, and follow-up time. Level IV, systematic review of Level I, III, and IV studies.Arthroscopy The Journal of Arthroscopic and Related Surgery 04/2014; 30(7). DOI:10.1016/j.arthro.2014.02.031 · 3.19 Impact Factor