2025 ISAKOS Biennial Congress ePoster
Increased Age, Weight, and Body Mass Index Increase the Likelihood of Total Knee Replacement Following Anterior Cruciate Ligament Reconstruction
Jessica Sheldon, BS, Columbus, Ohio UNITED STATES
Sonu Bae, BS, Columbus, Ohio UNITED STATES
Parker Cavendish, BS, Columbus, Ohio UNITED STATES
Eric Milliron, BS, Columbus, Ohio UNITED STATES
Spencer E. Talentino, MD, Columbus, OH UNITED STATES
Tyler Barker, PhD, Columbus, Ohio UNITED STATES
Christopher C. Kaeding, MD, Columbus, OH UNITED STATES
David C. Flanigan, MD, Columbus, OH UNITED STATES
Robert A Magnussen, MD, MPH, Worthington, OH UNITED STATES
The Ohio State University, Columbus, Ohio, UNITED STATES
FDA Status Cleared
Summary
Increased age, weight, and BMI increase the likelihood of total knee replacement following ACL reconstruction
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Abstract
Objective
Patients who have undergone anterior cruciate ligament reconstruction (ACLR) are at a higher risk of developing knee osteoarthritis (OA) and may undergo total knee arthroplasty (TKA) sooner than the general population. Demographics and peripheral inflammation are linked to OA, but the association of biometrics and peripheral inflammatory markers on the need for TKA remains unclear. This study aimed to determine if biometrics and peripheral inflammatory markers increase the likelihood of TKA following ACLR.
Methods
A single-center retrospective, case-control study was conducted on patients that underwent ACLR. Three groups of ACLR patients (n=15/group) were included with subsequent complete blood count data and: 1) with a subsequent TKA procedure (cases), 2) without a documented diagnosis of knee OA or TKA procedure (control-1), and 3) with a documented knee OA diagnosis but without a subsequent TKA procedure (control-2). Control groups were matched (1:1:1) to cases based on sex and date of surgery. Logistic regression analysis examined risk factors including age, body mass index (BMI), systemic immune-inflammatory index (SII), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR), neutrophil to lymphocyte ratio (NLR), and systemic inflammation response index (SIRI) for TKA (i.e., cases [n=15] vs control groups [n=30]).
Results
Age (46.8; p=0.05) and body mass (108kg; p <0.01) and BMI (35.3; p<0.01) at the time of ACLR were significantly increased in the cases that underwent subsequent TKA compared to the control groups. Peripheral indices of inflammation (PLR, MLR, NLR, SIRI, and SII) were not significantly different between groups. Logistic regression results indicate that increasing age and BMI were significant risk factors for TKA following ACLR.
Conclusions
Higher BMI and older age at the time of ACLR were significant predictors for undergoing TKA, highlighting the need for targeted interventions to prevent TKA in high-risk patients.