title: The adverse effect of elevated body mass index on outcome after autologous chondrocyte implantation.
abstract: We analysed whether a high body mass index (BMI)   had a deleterious effect on outcome following autologous chondrocyte   implantation (ACI) or matrix-carried autologous chondrocyte implantation   (MACI) for the treatment of full-thickness chondral defects of the   knee from a subset of patients enrolled in the ACI vs MACI trial   at The Royal National Orthopaedic Hospital. The mean Modified Cincinnati scores (MCS) were significantly   higher (p < 0.001) post-operatively in patients who had an ideal   body weight (n = 53; 20 to 24.9 kg/m(2)) than in overweight   (n = 63; 25 to 30 kg/m(2)) and obese patients (n = 22;   > 30 kg/m(2)). At a follow-up of two years, obese patients   demonstrated no sustained improvement in the MCS. Patients with   an ideal weight experienced significant improvements as early as   six months after surgery (p = 0.007). In total, 82% of patients   (31 of 38) in the ideal group had a good or excellent result, compared   with 49% (22 of 45) of the overweight and 5.5% (one of 18) in the   obese group (p < 0.001). There was a significant negative relationship between   BMI and the MCS 24 months after surgery (r = -0.4, p = 0.001). This study demonstrates that obese patients have worse knee function   before surgery and experience no sustained benefit from ACI or MACI   at two years after surgery. There was a correlation between increasing   BMI and a lower MCS according to a linear regression analysis. On   the basis of our findings patient selection can be more appropriately   targeted.
authors.affiliation: Royal National Orthopaedic Hospital, Institute of Orthopaedics and Musculoskeletal Sciences, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK. pkjresearch@gmail.com
authors.forename: P K
authors.initials: PK
authors.lastname: Jaiswal
authors.forename: G
authors.initials: G
authors.lastname: Bentley
authors.forename: R W J
authors.initials: RW
authors.lastname: Carrington
authors.forename: J A
authors.initials: JA
authors.lastname: Skinner
authors.forename: T W R
authors.initials: TW
authors.lastname: Briggs
mesh_terms: D000328:Adult; D001182:Arthroscopy; D015992:Body Mass Index; D019902:Chondrocytes / Q000637:transplantation*; D005500:Follow-Up Studies; D006801:Humans; D007592:Joint Diseases / Q000209:etiology / Q000601:surgery*; D007719:Knee Joint; D050177:Overweight / Q000150:complications*; D014182:Transplantation, Autologous; D017211:Treatment Failure; D016896:Treatment Outcome