Preinjury Aerobic Fitness Predicts Postoperative Outcome and Activity Level After Acetabular Fracture Fixation.
Phruetthiphat, Ong-art MD; Koehler, Daniel M. MD; Karam, Matthew D. MD; Rungprai, Chamnanni MD; Gao, Yubo PhD; Marsh, J. Lawrence MD
Journal of Orthopaedic Trauma.
30(8):e267-e272, August 2016.
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Objectives: To investigate whether aerobic fitness as determined by preoperative metabolic equivalents (METS) better predicts postoperative functional outcomes after open reduction and internal fixation (ORIF) of acetabular fractures than chronologic age.
Design: Retrospective review.
Setting: Level 1 Trauma Center.
Patients/Participants: A total of 157 patients underwent open surgical treatment for acetabular fracture between January 2005 and December 2013 with age >=18 years and minimum 1-year follow-up inclusive of imaging, functional outcome scores, and complications.
Intervention: ORIF of acetabular fracture.
Main Outcome Measurements: Final postoperative functional outcomes as assessed with the University of California Los Angeles activity score and the Western Ontario and McMaster Universities Osteoarthritis Index.
Results: Multivariate logistic regression analysis demonstrated elevated preinjury METS, female gender, and lower injury severity score (<18) to be significant independent factors predictive of improved functional outcome per the University of California Los Angeles score. Similarly, preinjury METS were identified as significant predictors for improved Western Ontario and McMaster Universities Osteoarthritis Index scores for both the stiffness and physical function components. Chronologic age was not a significant predictor for any functional outcome score. Furthermore, a Pearson correlation analysis demonstrated a weak relationship between preoperative METS and chronologic age (r = -0.346).
Conclusions: Pre-operative aerobic fitness as determined by METS may prove to be a superior prognostic factor for predicting postoperative functional outcome after acetabular fracture fixation than chronologic age. Consideration of aerobic fitness, in addition to other established prognostic factors, may be useful to patients and surgeons for injury counseling purposes.
Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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