Body mass index correlates with pain, functional recovery and complications in anterior talofibular ligament arthroscopic surgery.

Objective: To explore the correlation between body mass index (BMI) and ankle joint function recovery and rehabilitation outcomes in patients with anterior talofibular ligament (ATFL) injury after arthroscopic surgery.

Methods: A retrospective study was conducted on 106 ATFL injury patients who underwent arthroscopic ATFL reconstruction in The First People's Hospital of Jiashan from January 2021 to December 2023. Based on BMI, the patients were divided into non-overweight (BMI 18.5-23.9 kg/m), overweight (BMI 24.0-27.9 kg/m), and obesity (BMI > 28.0 kg/m) groups. Intraoperative parameters, preoperative and postoperative pain were measured by visual analogue scale (VAS), ankle function was evaluated by American Orthopedic Foot and Ankle Society (AOFAS) and Carlson Ankle Function Score (KAFS), and postoperative complications were compared among the three groups. The relationship between BMI and postoperative ankle function recovery was analyzed.

Results: Postoperative VAS scores decreased remarkably across all three groups, with non-overweight group exhibiting the lowest VAS score, followed by overweight and obesity groups (P < 0.05). AOFAS and KAFS scores notably increased after surgery in all three groups, with non-overweight group demonstrating the most obvious improvement, followed by overweight and obesity groups (P < 0.05). Complications incidence was 4.35%, 17.95%, and 58.62% in non-overweight, overweight, and obesity groups, respectively (P < 0.05). BMI correlated positively with VAS and negatively with AOFAS and KAFS.

Conclusion: Higher BMI is associated with more server post-surgical pain, worse ankle function recovery, and poorer rehabilitation outcomes.