Weight Not a Factor in Outcome of Arthroscopic Partial Meniscectomy

Obese patients are defined as those having a body mass index (BMI) greater than 30, overweight patients are those with a BMI from 25 to 30, while normal weight patients are those with a BMI less than 25.

Published in The Journal of Arthroscopic and Related Surgery, the study found no statistical difference in outcomes between patients one year after surgery.

Despite the presence of worse pain, physical function and quality of life scores and decreased flexion among obese patients prior to arthroscopic partial meniscectomy, results showed no statistically significant differences in clinical outcomes between normal weight and obese patients at one-year follow-up.

The new study was a secondary analysis of their ChAMP (Chondral Lesions and Meniscus Procedures) double-blind randomized controlled trial, designed to compare debridement versus observation of chondral lesions encountered during arthroscopic partial meniscectomy.

The researchers noted the ChAMP trial offered a distinct opportunity to examine the association between BMI and outcomes in patients without radiographic evidence of substantial degenerative joint disease because this population was excluded from the trial.

Senior author Leslie J. Bisson, MD, June A. and Eugene R. Mindell, MD, Professor and Chair of orthopaedics, says the results should enable orthopaedic surgeons to feel confident in the short term that their patients’ body weight won’t affect outcomes.

“The most important finding of this study was that being overweight and being obese were not associated with outcomes of pain, stiffness, knee symptoms, function, activity, quality of life or joint effusion,” Bisson says.

“Past studies have found increased BMI to be associated with worse outcomes following arthroscopic meniscal surgery, but these studies may have been confounded by the facts that higher BMI is associated with chondral lesions and that chondral lesions are associated with poorer outcomes after arthroscopy,” he adds.

Study participants were recruited by six sports medicine fellowship–trained orthopaedic surgeons at a single center and consented to participate.

A total of 50 normal weight, 100 overweight and 106 obese patients were studied in the final analysis.

All patients in the study underwent arthroscopic partial meniscectomy of the medial meniscus, lateral meniscus, or both menisci, at which time the articular cartilage was examined.

Melissa A. Kluczynski, clinical research associate in the Department of Orthopaedics, is the paper’s first author.

Co-authors from the Department of Orthopaedics and UBMD Orthopaedics  & Sports Medicine are:

• Geoffrey A. Bernas, MD, clinical assistant professor
• Marc S. Fineberg, MD, clinical associate professor
• John M. Marzo, MD, clinical professor
• Michael A. Rauh, MD, clinical assistant professor
• William M. Wind, MD, clinical assistant professor

Co-authors from the Department of Biostatistics in the School of Public Health and Health Professions are:

• Zehua Zhou, a student
• Jiwei Zhao, PhD, assistant professor

The Ralph C. Wilson Jr. Foundation funded the study.