Influence of the BMI (<30 kg/m² vs. ≥30 kg/m²) on the Surgical Outcome of Osteochondral Lesions of the Talus  : Prospective Data from the German Cartilage Registry (KnorpelRegister DGOU)

ObjectiveAim of this study was to evaluate the 24 months follow-up data of the German Cartilage Registry (KnorpelRegister DGOU, GCR) regarding the influence of body mass index (BMI) on clinical outcomes after surgical osteochondral lesions of the talus (OCT) treatment.DesignA total of 303 patients met the inclusion criteria. Pre- and post-operative Foot and Ankle Outcome Score (FAOS) total scores, subscores, and ΔFAOS were analyzed for most frequent surgical techniques (bone marrow stimulation [BMS], matrix-augmented BMS, matrix-augmented BMS with additional bone grafting) in normal weight group (NW, BMI <30 kg/m², n = 228) and obese weight group (OW, BMI ≥30 kg/m², n = 75).ResultsBMI was significantly different in NW and OW (24.6 ± 2.97 [16.9-29.9] kg/m² vs. 33.7 ± 4.0 [30.0-51.3] kg/m², P < 0.001). Significant improvement from pre- to post-operative FAOS score and subscales was reached in both groups (NW: 64.2 ± 17.5 vs. 77.7 ± 17.8; OW: 52.3 ± 15.5 vs. 73.5 ± 20.2; P < 0.001) with higher pre- and post-operative scores in NW. No significant difference in ΔFAOS score was detected. Treatment technique did not influence the clinical outcome. OW showed an extended use of bone grafting due to greater defect depth. Age was significantly higher in OW compared to NW (35.7 ± 13.2 [18.0-69.0] years vs. 40.7 ± 13.1 [18.0-77.0] years, P = 0.005).ConclusionsPatients benefit from surgical cartilage therapy regardless of their BMI. OW showed significantly lower pre- and post-operative FAOS scores. In OW, additional bone grafting was required more frequently due to significantly deeper defects.