Impact of BMI on Two-year Outcomes Following Meniscal Repairs and Meniscectomies in Pediatric and Adolescent Patients: A Nationwide Cohort Analysis.

BACKGROUND

The prevalence of meniscus injuries and subsequent reconstructions is increasing. Youth obesity has also increased and may put patients at a higher risk of post-operative complications.

HYPOTHESIS/PURPOSE: Our aim was to assess post-operative medical and orthopaedic outcomes as well as healthcare utilization following meniscus repairs and meniscectomies in pediatric and adolescent patients. We hypothesized that patients with a higher BMI would exhibit higher rates of post-operative complications.

METHODS

The TriNetX database was queried for patients 21 years of age or younger with a history of meniscus repairs or meniscectomies, yielding 8,355 patients. Three analyses were performed comparing patients with a BMI = 18.5-24.9 (healthy weight) to BMI ≤ 18.5 (underweight), BMI = 25-30 (overweight), and BMI = 30-35 (obese). Frequency of medical and orthopaedic complications as well as healthcare utilization was analyzed at 30, 90, and 180 days. Orthopaedic complications were also assessed at 2 years post-operatively. After Bonferroni correction, P < .001 was considered statistically significant.

RESULTS

Rates of most medical and orthopaedic complications were low in the overall cohort, never exceeding 0.43% and 1.22%, respectively. Prevalence of ED visits peaked at 4.21% at 180-day follow-up. The overall rate of revision meniscal surgery within 2-years was 9.08%. All medical outcomes and healthcare utilization rates were comparable between BMI cohorts.

CONCLUSIONS

Regardless of a patient's BMI, meniscus repairs and meniscectomies are generally safe in young patients.

KEY CONCEPTS: (1)Meniscus repairs and meniscectomies are safe procedures for children.(2)Body mass index does not impact post-operative medical outcomes.(3)Unlike adults, obesity does not impact post-operative orthopaedic outcomes and rates of revision surgery.

LEVEL OF EVIDENCE: III.