Height, weight, and BMI predict intra-articular injuries observed during ACL reconstruction: Evaluation of 456 cases from a prospective ACL database

Objective: To identify demographic and anthropometric risk factors for intra-articular (IA) injuries observed during ACL reconstruction. We hypothesize that significant associations exist among height, weight, and body mass index (BMI) with IA injuries when ACL tear occurs. Design: This observational study of a prospective multi-investigator ACL database used logistic and Poisson regression analysis to assess independent predictors of IA injuries. Setting: Vanderbilt Sports Medicine and affiliated tertiary care center. Patients: Patients undergoing unilateral ACL reconstruction without prior injury to either knee were identified from a detailed prospective ACL reconstruction database. Four hundred fifty-six patients met inclusion/exclusion criteria. Interventions: Per inclusion criteria, all patients underwent unilateral ACL reconstruction after assessment of injury profile. Main Outcome Measurements: The ACL database was initiated in 1990 to identify demographic, anthropometric, and mechanistic variables associated with intra-articular injury. Results: Height best predicted tibial and patellar damage. BMI better predicted medial femoral condyle lesions, whereas weight better predicted lateral and patellofemoral injury. BMI and weight equally predicted injury to menisci and medial tibial plateau. Through different outcomes, age (odd ratio [OR], 1.49; 95% Cl, 1.02-2.16), height (OR, 2.66; 95% Cl, 1.52-4.65), weight (OR, 1.02; 95% CI, 1.01-1.04), and BMI (OR, 1.24; 95% Cl, 1.004-1.53) were all significant predictors of intra-articular injury. Conclusions: This is the first report using multivariable analysis of age, height, weight, and BMI to evaluate associations with IA injuries after ACL rupture observed during ACL reconstruction. We hypothesize that athletes possibly could reduce risk of certain IA pathologies with maintenance of lower body weight and BMI and thus potentially improve long-term functional outcomes after ACL reconstruction.