Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 6, 2023; 11(19): 4567-4578
Published online Jul 6, 2023. doi: 10.12998/wjcc.v11.i19.4567
Assessment of functional prognosis of anterior cruciate ligament reconstruction in athletes based on a body shape index
Yun-Jun Wang, Jun-Chang Zhang, Yu-Ze Zhang, Ying-Hai Liu
Yun-Jun Wang, Yu-Ze Zhang, Ying-Hai Liu, Institutes of Biomedical Sciences, Shanxi University, Taiyuan 030006, Shanxi Province, China
Jun-Chang Zhang, Department of Orthopedics, First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
Author contributions: Wang YJ carried out the acquisition and interpretation of data and was the major contributor to drafting the manuscript; Wang YJ and Zhang JC carried out the clinical partial data collection and analyses; Wang YJ and Zhang YZ participated in drawing tables and diagrams; Zhang YZ was responsible for correcting the language and grammar; Zhang JC was responsible for reviewing and revising some drawings and tables; Zhang JC and Liu YH were responsible for guiding clinical discussions; Liu YH contributed to the ideas of the article and reviewed the manuscript; All authors provided final approval for publishing the manuscript.
Institutional review board statement: According to the Helsinki Declaration, the study was approved by the Ethics Committee of First Hospital of Shanxi Medical University.
Informed consent statement: The data used in this study were not involved in the patients’ privacy information, so the informed consent was waived by the Ethics Committee of First Hospital of Shanxi Medical University. All patient data obtained, recorded, and managed only used for this study, and all patient information are strictly confidential, without any harm to the patient.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ying-Hai Liu, PhD, Professor, Institutes of Biomedical Sciences, Shanxi University, No. 92 Wucheng Road, Taiyuan 030006, Shanxi Province, China. liuyinghai3699@163.com
Received: May 4, 2023
Peer-review started: May 4, 2023
First decision: May 12, 2023
Revised: May 21, 2023
Accepted: May 24, 2023
Article in press: May 24, 2023
Published online: July 6, 2023
Abstract
BACKGROUND

A healthy body shape is essential to maintain athletes’ sports level. At present, little is known about the effect of athletes’ body shape on anterior cruciate ligament reconstruction (ACLR). Moreover, the relationship between body shape and variables such as knee joint function after operation and return to the field has not been well studied.

AIM

To verify the relationship between a body shape index (ABSI) and the functional prognosis of the knee after ACLR in athletes with ACL injuries.

METHODS

We reviewed 76 athletes with unilateral ACL ruptures who underwent ACLR surgery in the First Hospital of Shanxi Medical University between 2017 and 2020, with a follow-up period of more than 24 mo. First, all populations were divided into a High-ABSI group (ABSI > 0.835, n = 38) and a Low-ABSI group (ABSI < 0.835, n = 38) based on the arithmetic median (0.835) of ABSI values. The primary exposure factor was ABSI, and the outcome indicators were knee function scores as well as postoperative complications. The correlation between ABSI and postoperative knee function scores and postoperative complications after ACLR were analyzed using multifactorial logistic regression.

RESULTS

The preoperative knee function scores of the two groups were similar. The surgery and postoperative rehabilitation exercises, range of motion (ROM) compliance rate, Lysholm score, and Knee Injury and Osteoarthritis Outcome Score of the two groups gradually increased, whereas the quadriceps atrophy index gradually decreased. The knee function scores were higher in the Low-ABSI group than in the High-ABSI group at the 24-mo postoperative follow-up (P < 0.05). In multifactorial logistic regression, ABSI was a risk factor of low knee joint function score after surgery, specifically low ROM scores (odds ratio [OR] = 1.31, 95% confidence interval [CI] [1.10-1.44]; P < 0.001), low quadriceps atrophy index (OR = 1.11, 95%CI [0.97-1.29]; P < 0.05), low Lysholm scores (OR = 2.34, 95%CI [1.78-2.94]; P < 0.001), low symptoms (OR = 1.14, 95%CI [1.02-1.34]; P < 0.05), low activity of daily living (OR = 1.34, 95%CI [1.18-1.65]; P < 0.05), low sports (OR = 2.47, 95%CI [1.78-2.84]; P < 0.001), and low quality of life (OR = 3.34, 95%CI [2.88-3.94]; P < 0.001). ABSI was also a risk factor for deep vein thrombosis of the lower limb (OR = 2.14, 95%CI [1.88-2.36], P < 0.05] and ACL recurrent rupture (OR = 1.24, 95%CI [0.98-1.44], P < 0.05) after ACLR.

CONCLUSION

ABSI is a risk factor for the poor prognosis of knee function in ACL athletes after ACLR, and the risk of poor knee function after ACLR, deep vein thrombosis of lower limb, and ACL recurrent rupture gradually increases with the rise of ABSI.

Keywords: A body shape index, Anterior cruciate ligament reconstruction, Athletes, Multifactorial logistic regression, Obesity

Core Tip: A body shape index (ABSI), an excellent body mass index, was used to substitute for the traditional body mass index to more objectively assess the degree of body size/obesity in athletes. Subsequently, multivariate logistic regression analysis was used to determine whether ABSI is a risk factor for poor knee function, lower extremity deep vein thrombosis, and fractures after anterior cruciate ligament surgery. The findings of this study have the potential to narrow the gap in previous research.