Abstract
BackgroundIncreased body mass index (BMI) has been associated with poorer function in patients who have undergone anterior cruciate ligament (ACL) reconstruction. However, the effect of high BMI on muscle strength in these patients remained unclear. The current study aimed to compare knee muscle strength and Knee injury and Osteoarthritis Outcome Score (KOOS) in ACL-reconstructed patients with a variety of different BMIs.MethodsFrom November 2013 to March 2016, we prospectively enrolled 30 patients who underwent ACL reconstruction (18–60 years of age). Anthropometric parameters, body compositions, isokinetic muscle strength and KOOS were assessed preoperatively, and at post-operative 16th week and 28th week. The patients were stratified into two groups by BMI, i.e. normal BMI (18.5–24.9 kg/m2) and high BMI (≥25.0 kg/m2).ResultsTwelve patients in the normal BMI group completed the follow-up, while sixteen patients did so in the high BMI group. In comparison of muscle strength between baseline and 28th week follow-up, the normal BMI group had significant increases in overall knee muscle strength, while the high BMI group only had increases in extensors of uninjured knee and flexors of the injured knee. However, there were significant increases in all KOOS subscales for the high BMI group. The high BMI patients reported increased KOOS, which may reflect the contribution of ligament stability in the presence of inadequate muscle strength.ConclusionsThe normal BMI patients had improvement in all knee muscle strength following ACL reconstruction, while high BMI patients only had increases in certain knee muscles. High BMI patients had a decreased quadriceps muscle symmetry index, as compared to their normal BMI counterparts. Increases in quadriceps muscle strength of the uninjured knee and ACL reconstruction were associated with improvements in KOOS in high BMI patients.
Highlights
Increased body mass index (BMI) has been associated with poorer function in patients who have undergone anterior cruciate ligament (ACL) reconstruction
Twenty-eight patients completed the follow-up test at 28 weeks, including twelve patients in the normal BMI group (BMI = 18.5–24.9 kg/m2) and sixteen in the high BMI group (BMI ≥25.0 kg/m2)
We observed a temporary increase in body fat in both the normal and high BMI groups at 16 weeks following ACL reconstruction, returning to previous level at 28 weeks
Summary
Increased body mass index (BMI) has been associated with poorer function in patients who have undergone anterior cruciate ligament (ACL) reconstruction. The effect of high BMI on muscle strength in these patients remained unclear. Many factors have been suggested as contributing to self-reported function results for ACL reconstruction, including quadriceps index, pain intensity, and flexion motion deficit [2]. The effect of body mass index (BMI) on long-term outcome for ACL reconstruction patients remained unclear [3]. Increased BMI has been associated with poorer functional outcomes following ACL reconstruction [4, 5]. ACL reconstruction has been suggested as an effective treatment irrespective of preoperative BMI [6]. Whether the quadriceps recovers well is a major concern for function following ACL injury and reconstruction, as well as a determining factor in the development
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