title: Preinjury Aerobic Fitness Predicts Postoperative Outcome and Activity Level After Acetabular Fracture Fixation.
abstract: OBJECTIVE
  To investigate whether aerobic fitness as determined by preoperative metabolic equivalents (METS) better predicts postoperative functional outcomes after open reduction and internal fixation (ORIF) of acetabular fractures than chronologic age.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Level 1 Trauma Center.
  
  
  METHODS
  A total of 157 patients underwent open surgical treatment for acetabular fracture between January 2005 and December 2013 with age ≥18 years and minimum 1-year follow-up inclusive of imaging, functional outcome scores, and complications.
  
  
  METHODS
  ORIF of acetabular fracture.
  
  
  METHODS
  Final postoperative functional outcomes as assessed with the University of California Los Angeles activity score and the Western Ontario and McMaster Universities Osteoarthritis Index.
  
  
  RESULTS
  Multivariate logistic regression analysis demonstrated elevated preinjury METS, female gender, and lower injury severity score (<18) to be significant independent factors predictive of improved functional outcome per the University of California Los Angeles score. Similarly, preinjury METS were identified as significant predictors for improved Western Ontario and McMaster Universities Osteoarthritis Index scores for both the stiffness and physical function components. Chronologic age was not a significant predictor for any functional outcome score. Furthermore, a Pearson correlation analysis demonstrated a weak relationship between preoperative METS and chronologic age (r = -0.346).
  
  
  CONCLUSIONS
  Pre-operative aerobic fitness as determined by METS may prove to be a superior prognostic factor for predicting postoperative functional outcome after acetabular fracture fixation than chronologic age. Consideration of aerobic fitness, in addition to other established prognostic factors, may be useful to patients and surgeons for injury counseling purposes.
  
  
  METHODS
  Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: *Department of Orthopaedic Surgery and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA; and†Department of Orthopaedic Surgery, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand.
authors.forename: Ong-Art
authors.initials: OA
authors.lastname: Phruetthiphat
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Koehler
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Karam
authors.forename: Chamnanni
authors.initials: C
authors.lastname: Rungprai
authors.forename: Yubo
authors.initials: Y
authors.lastname: Gao
authors.forename: J Lawrence
authors.initials: JL
authors.lastname: Marsh
mesh_terms: D000077:Acetabulum / Q000293:injuries* / Q000601:surgery*; D000203:Activities of Daily Living; D000328:Adult; D015444:Exercise; D005080:Exercise Test / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D005593:Fracture Fixation, Internal; D017102:Fracture Healing; D050723:Fractures, Bone / Q000175:diagnosis* / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D007484:Iowa / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D055815:Young Adult