Elective Sports Surgery Leads to Postoperative Weight Changes in Pediatric Patients

BACKGROUND: Patients who undergo orthopaedic surgeries often have activity restrictions during postoperative recovery. It is unknown whether these extended periods of reduced activity lead to postoperative weight changes in pediatric patients. PURPOSE: The purpose of this study was to evaluate changes in body mass index (BMI) percentile in children and adolescents following primary sports surgeries. METHODS: After institutional review board (IRB) approval was obtained, institutional records for utilized current procedural terminology (CPT) codes were used to identify patients who underwent elective sports surgery at a single pediatric orthopaedic institution between October 2016 and December 2018. Non-primary surgeries and patients without preoperative BMI measurements were excluded. Demographic characteristics, height, weight, and BMI at every follow-up visit within 30 months of surgery were collected. To account for expected growth with age, BMI percentiles were calculated. Statistical analysis of changes in BMI percentile at follow-up intervals of 3-7 months, 9-18 months, and 24-30 months after surgery was performed. Analyses were also performed based on preoperative BMI category (underweight, normal-weight, overweight, or obese, per Centers for Disease Control definitions) and upper- or lower-extremity surgery. RESULTS: A total of 468 patients (50.4% female, average age 14.5 years) were available for study. Seven patients (1.5%) were underweight at the time of surgery, 262 normal-weight (56%), 87 overweight (18.6%), and 112 obese (23.9%). Sixty-nine surgeries were performed on the upper extremity, while 399 were on the lower extremity. While on average patients demonstrated a tendency to increase BMI percentile at each follow-up interval, these values did not reach significance. However, analysis by preoperative BMI category revealed that at 24-30 months after surgery, normal-weight patients had increased BMI percentile by 6.74 points (p = .041) compared to baseline, while overweight patients had decreased BMI percentile by 17.65 points (p = .020) (Table 1). By final follow-up, 32 of 262 initially normal-weight patients had increased their weight category to overweight or obese, while 40 patients who were initially overweight or obese had favorable decreases in weight category. CONCLUSION: Children and adolescents undergoing primary sports surgeries may experience postoperative changes in BMI percentile. Normal-weight patients tend to increase weight, while overweight patients may decrease weight over 2.5 years after surgery.