BMI对儿童青少年半月板修复与切除术两年预后的影响：一项全国性队列分析
简介
该研究利用TriNetX数据库纳入8,355名≤21岁接受半月板修复或切除术的患者，按体重指数（BMI）分为健康体重组（18.5–24.9）、低体重组（≤18.5）、超重组（25–30）和肥胖组（30–35），比较术后30、90、180天及2年的内科与骨科并发症及医疗资源使用情况。关键发现：总体并发症发生率低（内科≤0.43%，骨科≤1.22%），急诊就诊率…
英文摘要
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.