Increased BMI has been linked to increased risk of meniscal tears, yet outcomes following meniscus repair in these patients remain unclear. This study aims to compare post-traumatic meniscus repair failure rates and return to sport outcomes in pediatric and adolescent populations based on weight, BMI, BMI percentile, and CDC BMI Category. This retrospective cohort study included patients aged <19 years who underwent meniscus repair at our multi-center institution between 2017 and 2023, including both isolated and concomitant repairs. The primary outcome was meniscus repair failure, defined as clinical, radiographic, and/or intraoperative evidence of meniscal pathology, or the need for additional surgical intervention at the meniscus. Secondary outcomes included Return to Sport (RTS) and Return to Sport at Pre-Injury Level (RTSPIL). An analysis of outcomes by weight, BMI, BMI percentile, and weight category was performed. 203 patients were included (54.0% female, mean age 15.7±1.7 years, weight 69.8±19.7 kg, and BMI 24.3±5.5 kg/m²), with a mean follow-up of 23.3±13.9 months. Overall repair failure rate was 24.6%. Patients with meniscus failure were significantly heavier (p < .05) with higher BMIs (p < .001) than those without, but they did not differ in BMI percentile (p = .10). There were no significant differences in weight, BMI, or BMI percentile for those who failed to RTS or RTSPIL, compared to those who successfully returned. Increasing BMI categories showed higher rates of failure, failure to RTS, and failure to RTSPIL. Meniscus failure and failure to RTS did not vary based on age, follow-up, or gender. This study identifies elevated rates of meniscal repair failure in pediatric and adolescent patients who have increased weight and BMI. Notably, this association was not demonstrated for BMI percentile. None of these measures predicted return to sport, suggesting functional recovery depends on factors beyond body composition. Thus, surgeons must retain a heightened clinical awareness and perform close postoperative monitoring following meniscus repair in patients with elevated weight and BMI. III, Retrospective Cohort
Reikersdorfer et al. (Sun,) studied this question.