Кореляційні зв’язки між інтенсивністю болю, функціональним відновленням колінного суглоба та клініко-лабораторними характеристиками у пацієнтів із ожирінням після реконструкції передньої хрестоподібної зв’язки

Abstract

Aim. To assess the impact of obesity and clinical-anamnestic characteristics of patients with isolated ACL injury on pain intensity and functional status of the knee joint in the early postoperative period. Materials and methods. A prospective single-center study was conducted involving 38 patients aged 19–67 years with isolated anterior cruciate ligament injury and obesity, defined as body mass index ≥ 30 kg/m². Correlation relationships between pain intensity according to the Visual Analog Scale, knee functional status according to the Lysholm score, and clinical-anamnestic, anthropometric, laboratory, and instrumental charac-teristics were analyzed. Pain intensity and functional status were assessed at four time points: before surgery, 1 week, 1 month, and 2 months after reconstruction. Results. In obese patients, preoperative pain intensity according to the VAS showed statistically significant posi-tive correlations with BMI (r = 0.439; p = 0.006), very low-density lipoproteins (r = 0.575; p = 0.001), and total cholesterol (r = 0.350; p = 0.031), and negative correlations with activated partial thromboplastin time (r = –0.385; p = 0.017) and high-density lipoproteins (r = –0.367; p = 0.024). At 1 week, 1 month, and 2 months, VAS pain scores remained significantly associated mainly with BMI (r = 0.341–0.462; p<0.05), and at 2 months also with systolic blood pressure (r = 0.397; p = 0.014). Lysholm scores before surgery negatively correlated with BMI (r = –0.414; p = 0.010) and triglycerides (r = –0.342; p = 0.036). At 1 week and 1 month after arthroscopic reconstruction, Lysholm scores remained associated with BMI (r = –0.550 and –0.503; p ≤ 0.001) and triglycerides (r = –0.454 and –0.402; p<0.05). Conclusions. Obesity and an unfavorable metabolic profile are associated with higher pain intensity and slower functional recovery of the knee joint after ACL reconstruction. These findings highlight the need for a personalized approach to analgesia and rehabilitation in overweight patients undergoing arthroscopic ACL reconstruction