{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T08:31:51Z","timestamp":1777710711417,"version":"3.51.4"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T00:00:00Z","timestamp":1740009600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007307","name":"Arthrex","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007307","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016178","name":"Medwest Associates","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016178","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009026","name":"Smith and Nephew","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007307","name":"Arthrex","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007307","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["arthroscopysportsmedicineandrehabilitation.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy, Sports Medicine, and Rehabil."],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To examine outcomes following surgically treated multiligamentous knee injuries (MLKIs) in obese versus nonobese patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients who were surgically treated for MLKIs between 2008 and 2021 were included in this study. Patients were divided into 2 groups and classified as obese (body mass index \u226530) or nonobese. The following patient\u2010reported outcome measures were collected: the visual analog scale for pain, the International Knee Documentation Committee subjective score, and the Lysholm knee scoring scale. Complications such as revision ligamentous reconstruction, conversion to total knee arthroplasty (TKA), infection, and arthrofibrosis were also documented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 88 patients (88 knees; 43 obese, 45 nonobese) were included in the final analysis. The mean overall age was 34.3 \u00b1 12.7 years (10\u201061 years), and there were 30 women and 58 men included in this study cohort. The mean follow\u2010up for the patients who did not receive a revision or TKA was 9.2 years (range, 3.4\u201015.3 years). There were no differences seen between groups for age, sex, mechanism of injury, neurovascular status, concomitant injuries, frank knee dislocations, surgical staging, or external fixator application. However, the mean follow\u2010up in the nonobese group was higher than in the obese group (9.7 vs 8.3 years,\n                      <jats:italic>P<\/jats:italic>\n                      = .003). The nonobese cohort had significantly more open injuries compared to the obese cohort (11.1% vs 2.3%,\n                      <jats:italic>P<\/jats:italic>\n                      = .05). Although there were no differences seen in conversion to TKA or arthrofibrosis, the obese cohort had a higher rate of ligament failure (30.2% vs 8.9%,\n                      <jats:italic>P<\/jats:italic>\n                      = .02) and infection (14% vs 2.2%,\n                      <jats:italic>P<\/jats:italic>\n                      = .05). Additionally, the obese cohort had worse visual analog scale for pain scores (4.4 vs 2.2,\n                      <jats:italic>P<\/jats:italic>\n                      = .002), lower International Knee Documentation Committee scores (50.3 vs 74.6,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), and lower Lysholm scores (59.9 vs 80.6,\n                      <jats:italic>P<\/jats:italic>\n                      = .004) at final follow\u2010up compared to the nonobese cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Obese patients had significantly higher rates of ligament failure and infection rates, higher pain scores, and worse patient\u2010reported outcomes than nonobese patients following surgically treated MLKIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.asmr.2025.101111","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T11:25:55Z","timestamp":1740569155000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":3,"title":["Obese Patients Demonstrate Higher Failure Rates, Infection Rates, and Inferior Patient\u2010Reported Outcomes Compared With Nonobese Patients Following Multiligamentous Knee Surgery"],"prefix":"10.1002","volume":"7","author":[{"given":"Adam V.","family":"Daniel","sequence":"first","affiliation":[{"name":"Orlando Health Jewett Orthopedic Institute Orlando Florida U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Warren A.","family":"Williams","sequence":"additional","affiliation":[{"name":"Orlando Health Jewett Orthopedic Institute 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