Topic 14 · Everything else

Body Weight and BMI Impact

BMI at or above 30 predicts worse surgical outcomes. Modifiable, and worth modifying before any operation.

2025 German Cartilage Registry Data

→ Extra weight = more stress on ankle cartilage with every step. Obesity linked to worse surgical outcomes. Like driving on a weak tire - heavier load = faster wear. Weight management can significantly affect how well treatments work.

A 2025 study from the German Cartilage Registry (303 patients) examined BMI impact on OLT surgical outcomes [107]:

Both normal weight (BMI <30) and obese (BMI ≥30) groups showed significant improvement
Higher BMI associated with higher prevalence of ankle sprains and OCTs
Obesity incidence is rapidly increasing, making this clinically important

2024 JBJS Long-Term Survival

The 10-year survival study analyzed BMI as a risk factor for treatment failure [22]:

BMI ≥30 kg/m² was included as a prognostic factor
82% 10-year survival overall, with obesity as potential modifier

Takeaway: While not a contraindication to surgery, maintaining healthy weight optimizes outcomes.