Summary

Increased BMI is associated with increased failure and decreased return to sport following meniscus repair in the pediatric population.

Abstract

Purpose

The association between high BMI and risk of meniscus injury has been highlighted in the past, however, the risk of failure of subsequent meniscus repair remain unclear. This study aims to compare meniscus repair outcomes in the pediatric population based on weight, BMI, and BMI percentile.

Methods

This is retrospective cohort study included pediatric and adolescent patients who underwent meniscus repair 2017-2023. Meniscus repair failure was defined as the need for additional intervention or persistent clinical manifestations of meniscal pathology. Secondary outcomes evaluated was return to sport (RTS) and RTS at pre-injury level (RTSPIL). Repair failure, RTS, and RTSPIL were evaluated by weight, BMI, BMI percentile, and weight category.

Results

203 patients were included (54.0% female, mean age 15.7±1.7 years, weight 154.4±43.4 lbs, and BMI 24.3±5.5 kg/m²), with a mean follow-up of 23.3±13.9 months. Patients with graft failure were significantly heavier (p < .05) with higher BMIs (p < .001) than those without, but they did not differ in BMI percentile (p = .10). There were no significant differences in weight, BMI, or BMI percentile for those who failed to RTS or RTSPIL, compared to those who successfully returned (p’s > .09). Increased weight category showed higher rates of graft failure, fRTS, and fRTSPIL. Graft failure and fRTS did not vary based on age, follow-up, or gender.

Conclusions

Increased weight and BMI are associated with meniscus repair failure amongst pediatric and adolescent patients. However, weight, BMI, and BMI percentile did not significantly predict RTS outcomes. Considering patient body habitus is crucial in managing post-op recovery and evaluating the risks and benefits of meniscus repair versus meniscectomy in this population.