Correlation between Body Mass Index (BMI) and Early Postoperative Pain in Adults Undergoing Arthroscopic Partial Meniscectomy

Correlation between Body Mass Index (BMI) and Early Postoperative Pain in Adults Undergoing Arthroscopic Partial Meniscectomy | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Correlation between Body Mass Index (BMI) and Early Postoperative Pain in Adults Undergoing Arthroscopic Partial Meniscectomy Songlang Liu, Hongxing Liao, Yali Yang, Jianguang Sun This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5779191/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Arthroscopic partial meniscectomy surgery has become a common treatment for meniscal injuries; however, early postoperative pain significantly affects patient satisfaction with this surgery. Previous studies have largely explored the differences between arthroscopic partial meniscectomy and conservative rehabilitation, as well as factors affecting postoperative quality of life, with less focus on the relationship between the preoperative body mass index (BMI) and early postoperative pain following arthroscopic partial meniscectomy. This study is based on early feedback from patients after arthroscopic meniscal repair surgery, where the primary concern is early postoperative pain, to analyze the correlation between preoperative BMI and early postoperative pain after arthroscopic meniscal repair in adults. Methods We retrospectively analyzed clinical data from 221 adult patients who underwent arthroscopic partial meniscectomy at Meizhou People's Hospital, Guangdong Province, China, in 2023. Univariate and multivariate logistic regression analyses, stratified analysis, and threshold effect assessment were employed to evaluate the impact of preoperative BMI, age, sex, disease duration, cartilage injury severity, and meniscal injury grade on postoperative pain. A fitted curve between BMI and postoperative visual analog scale (VAS) score was plotted to visualize the correlation, and the model's efficacy was analyzed via receiver operating characteristic (ROC) curves. Results After adjusting for confounding factors through univariate and multivariate analyses, preoperative BMI ( β = 0.20, P < 0.01), with an odds ratio of 1.23 and a 95% confidence interval of 1.09–1.38, was identified as a significant factor influencing early postoperative pain. The relationship between the two variables was nonlinear, with a threshold effect revealing BMI = 25.7 as a critical inflection point, where pain significantly changed. The ROC curve analysis indicated that BMI has moderate predictive power for postoperative pain risk (AUC = 0.67). Conclusion A significant correlation exists between preoperative BMI and early postoperative pain following arthroscopic partial meniscectomy, with a nonlinear relationship and a key inflection point at BMI = 25.7. This finding can aid in the creation of personalized treatment, management and rehabilitation plans, thus improving patient satisfaction after surgery. Body Mass Index (BMI) Arthroscopic Partial Meniscectomy Visual Analogue Scale(VAS) Figures Figure 1 Figure 2 Figure 3 Introduction Knee pain is one of the most common clinical issues among adult patients, and meniscal injuries are a frequent cause of knee pain and functional impairment [ 1 ] . In the United States, meniscal injuries are the most common knee injuries, with an annual average incidence of 66 per 100,000 people [ 2 ] . The meniscus serves multiple crucial functions, including shock absorption, proprioception, knee joint stability, and lubrication [ 3 , 4 ] . Arthroscopic partial meniscectomy (APM) is a common treatment modality that minimizes soft tissue damage and shortens the hospital stay, making it one of the most frequently performed orthopedic surgeries globally [ 5 ] . However, approximately 80% of patients who undergo APM experience severe pain postoperatively, which hinders early recovery, particularly for those who are sensitive to pain, leading to poor recovery and limited knee function [ 6 ] . Most feedback from postsurgical patients is centered on pain; severe early postoperative pain can lead to decreased patient compliance, lower satisfaction, delayed ambulation and rehabilitation, increased hospital costs, and prolonged hospital stays. Therefore, exploring the causes of early postoperative pain in adults following APM is beneficial for improving patient satisfaction postoperatively, reducing the length of hospital stays, and facilitating early patient approval. The body mass index (BMI) is a globally recognized grading method for assessing the degree of obesity [ 7 ] . Currently, the World Health Organization also uses this metric to classify obese or overweight individuals. Obesity is believed to exacerbate chronic pain through various mechanisms, including increasing mechanical and metabolic stress and promoting the activation of inflammatory pathways [ 8 ] . When pain-related risk factors are evaluated in adult patients after knee meniscal reshaping surgery, diabetes and BMI are risk factors that affect patient satisfaction and readmission after all arthroscopy examinations [ 9 ] . Compared with average patients, many patients with higher BMIs experience more severe postoperative pain and require larger doses of analgesic medication. Previous studies have mostly explored the impact of preoperative cartilage damage, age, and the choice of surgical method on postoperative pain after arthroscopic partial meniscectomy, including WOMAC scores, articular cartilage damage, weight-bearing time < 1 week postoperatively, lack of cold compresses postoperatively, and open knee surgery as independent risk factors for postoperative pain [ 10 ] . Some studies also consider BMI as a factor influencing arthroscopy [ 11 ] . However, research on the correlation between preoperative BMI and early postoperative pain after knee meniscal reshaping surgery is lacking in the literature. This study focused on the relationship between preoperative BMI and early postoperative pain in adults after arthroscopic partial meniscectomy, with the aim of selecting appropriate treatment plans preoperatively, formulating individualized pain management, increasing patient satisfaction postoperatively, and including BMI as an important indicator in postoperative follow-up. This approach provides individualized exercise plans in later life to delay the onset of knee arthritis. Materials and Statistical Methods We extracted data from the hospital medical records database for 530 adult patients who underwent arthroscopic partial meniscectomy surgery in 2023, with a follow-up of 4 weeks postoperatively, via the visual analog scale (VAS) score. We defined a score of 0–4 as mild pain and a VAS score of 5 or above as moderate to severe pain. Ultimately, 221 patients were included in the study, with 120 patients experiencing mild pain and 101 patients experiencing moderate to severe pain. The inclusion criteria were as follows: (1) patients aged 18 years or above who underwent arthroscopic partial meniscectomy surgery; (2) patients with complete and accessible data on age, sex, disease duration, preoperative magnetic resonance imaging (MRI) assessment of cartilage damage, meniscal injury grade, and 4-week postoperative visual analog scale (VAS) score; (3) unilateral surgery; and (4) patient and family consent to use clinical data for research purposes. The exclusion criteria were as follows: (1) suspected preoperative knee joint infection, tuberculosis, or nonpure meniscal injuries or knee arthritis; (2) intraoperative procedures other than meniscal reshaping, such as platelet-rich plasma (PRP) injections into the joint cavity; (3) bilateral knee arthroscopic partial meniscectomy surgery; and (4) more than 10% missing data. See Fig. 1 . This study was supported by the Ethics Committee of Meizhou People's Hospital in Guangdong Province, China, (2024-C-198)and all procedures conducted in this study were in accordance with the Declaration of Helsinki in 1964. Study Indicators: The determination of study indicators is typically based on previous literature, statistically significant indicators, or clinical significance. This study included a total of seven indicators: age (years), sex (male, female), BMI (kg/m 2 ), disease duration (months), knee joint (left, right), degree of preoperative cartilage damage (Outerbridge grading, where grades 0–2 are defined as mild cartilage damage and grades 3–4 are defined as moderate to severe cartilage damage), meniscal injury grading from I to IV, and the outcome variable, the VAS score at 4 weeks postoperatively, where a VAS score of 0–4 is defined as mild pain and a VAS score of 5 or above is defined as moderate to severe pain. Statistical Methods: Data were analyzed via SPSS 25.0, EmpowerStats, and R language 4.1.2 statistical software. Quantitative data that conformed to a normal distribution are expressed as the mean ± standard deviation, and comparisons between two groups were made via independent samples t tests. Quantitative data that did not conform to a normal distribution are expressed as the median (25%-75%), and comparisons between two groups were made via the Mann‒Whitney U test. Categorical data are expressed as the number of cases, and comparisons between groups were made via chi-square tests or nonparametric rank sum tests. Univariate and multivariate logistic regression analyses were conducted, with statistically significant factors included for stratified analysis to obtain threshold effects. A fitted curve between BMI and postoperative VAS score was plotted, and the receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to assess the model's discriminative ability and calibration, visualizing the relationship between BMI and postoperative VAS score. Results The demographic and preoperative imaging data included age (years), sex (male, female), BMI (kg/m 2 ), disease duration (months), knee joint (left, right), degree of preoperative cartilage damage (mild, moderate to severe), meniscal injury grade (I-III), and early postoperative VAS score (mild pain, moderate to severe pain). Statistical analysis revealed that BMI had a P value less than 0.05, which was statistically significant, whereas the P values for sex, affected leg side, meniscal injury grade, and degree of cartilage damage were all greater than 0.05, indicating no significant difference. See Table 1 for details. Table 1 Comparison of general data between two groups of patients Variables Mild Pain(n = 120) moderate to severe pain (n = 101) P Age(years) 61.77 ± 11.82 61.41 ± 9.37 0.796 BMI(kg/m 2 ) 23.81 ± 2.62 24.89 ± 2.35 0.002 Course of disease (months) 12.72 ± 21.68 18.81 ± 29.34 0.078 Sex, n(%) 0.336 Male 29 (24.17) 19 (18.81) Female 91 (75.83) 82 (81.19) Knee joint (n,%) 0.844 Left 59 (49.17) 51 (50.50) Right 61 (50.83) 50 (49.50) Cartilage injury n(%) 0.382 Slight 35 (29.17) 35 (34.65) Gravity 85 (70.83) 66 (65.35) Meniscus, n(%) 0.108 Grade I 1 (0.83) 6 (5.94) Grade II 27 (22.50) 21 (20.79) GradeIII 92 (76.67) 74 (73.27) Through logistic regression models, we assessed the impact of various variables on early postoperative pain (VAS scores) following arthroscopic partial meniscectomy surgery. The logistic regression analysis results indicated that BMI was significantly associated with postoperative pain (odds ratio (OR), 1.23; 95% confidence interval (CI), 1.09–1.38; P < 0.01), suggesting that an increase in BMI could be an important factor for moderate-to-severe pain. The impact of meniscal injury grade III was nearly significant (P = 0.049), indicating that a longer disease duration is associated with increased postoperative pain. However, sex, affected knee side, and other factors did not significantly differ, suggesting that these variables may have a limited role in the pathophysiological mechanisms of postoperative pain, as shown in Table 2 . Table 2 Univariate Analysis and Multivariate Analysis Variables Univariate Analysis Multivariate Analysis β S.E Z P OR (95%CI) β S.E Z P OR (95%CI) Sex Man 1.00 1.00 Femal 0.32 0.33 0.96 0.337 1.38 (0.72–2.64) 0.22 0.35 0.63 0.526 1.25 (0.63–2.48) Knee joint Left 1.00 1.00 Right -0.05 0.27 -0.20 0.844 0.95 (0.56–1.61) -0.15 0.29 -0.54 0.590 0.86 (0.49–1.51) Cartilage injury n(%) Slight 1.00 1.00 Gravity -0.25 0.29 -0.87 0.383 0.78 (0.44–1.37) -0.23 0.34 -0.67 0.502 0.79 (0.41–1.55) Meniscus, n(%) Grade I 1.00 1.00 Grade II -2.04 1.12 -1.83 0.068 0.13 (0.01–1.16) -2.21 1.18 -1.88 0.061 0.11 (0.01–1.10) GradeIII -2.01 1.09 -1.84 0.065 0.13 (0.02–1.14) -2.30 1.17 -1.97 0.049 0.10 (0.01–0.99) Age(years) -0.00 0.01 -0.25 0.799 1.00 (0.97–1.02) -0.00 0.02 -0.24 0.810 1.00 (0.97–1.03) BMI(kg/m 2 ) 0.17 0.06 3.08 0.002 1.19 (1.07–1.33) 0.20 0.06 3.29 < .001 1.23 (1.09–1.38) Course of disease (months) 0.01 0.01 1.72 0.086 1.01 (1.00–1.02) 0.01 0.01 0.97 0.331 1.01 (0.99–1.02) BMI was divided into three levels, low, medium, and high, as follows: 16.94–23.12; 23.24–25.67; and 25.71–30.94 (kg/m 2 ), to observe the impact of each BMI level and adjusted variables on the postoperative VAS score. The results of the unadjusted model revealed that for each unit increase in BMI, the likelihood of early postoperative pain increased by 20%, OR = 1.2, 95% CI (1.1–1.3), P = 0.0020. In Model I, after adjusting for sex, the relationship between BMI and postoperative pain remained significant (OR = 1.2, 95% CI (1.1–1.4), P = 0.0010). After further adjustment for sex, age, affected knee, degree of cartilage damage, degree of meniscal damage, and disease duration in Model II, the relationship between BMI and postoperative pain remained robust (OR = 1.2, 95% CI (1.1–1.4), P = 0.0028). In the stratified analysis of BMI, a medium BMI was significantly associated with postoperative pain in adjusted Model I (OR = 2.1, 95% CI (1.0-4.3), P = 0.0362), whereas a high BMI was significantly associated with pain in all the models, especially in adjusted Model II (OR = 2.5, 95% CI (1.2–5.1), P = 0.0142). These results emphasize the correlation between BMI and early postoperative pain after arthroscopic partial meniscectomy surgery (Table 3 ). Table 3 Multivariate Regression Analysis Non-adjusted Adjust I Adjust II BMI 1.2 (1.1, 1.3) 0.0020 1.2 (1.1, 1.4) 0.0010 1.2 (1.1, 1.4) 0.0028 BMI Tertile Low 1.0 1.0 1.0 Middle 1.8 (0.9, 3.5) 0.0819 2.1 (1.0, 4.3) 0.0362 2.0 (1.0, 4.1) 0.0555 High 2.4 (1.3, 4.7) 0.0087 2.7 (1.3, 5.5) 0.0062 2.5 (1.2, 5.1) 0.0142 Table 3 Data: OR (95% CI) P-value, Outcome Variable: VAS, Exposure Variable: BMI; Minimum adjustment model adjusted for gender, Full adjustment model adjusted for gender, age, knee, meniscal injury, disease duration, and degree of cartilage damage. Figure 2 illustrates the curve fitting between BMI and pain after arthroscopic partial meniscectomy surgery, further revealing the nonlinear relationship between BMI and pain risk and providing a visual representation. Table 4 shows the threshold effect of BMI on early postoperative VAS score, characterized by a clear inflection point at BMI = 25.7. Below this inflection point, the OR was 1.3, with a 95% CI (1.1, 1.6) and P < 0.01, indicating that the VAS score significantly increased with increasing BMI, indicating a strong positive correlation. However, when the BMI exceeds 25.7, the OR is 0.9, with a 95% CI (0.6, 1.2) and P = 0.049, indicating that the increase in the VAS score is no longer significant. Table 4 Threshold Effect Outcome OR (95% CI) P-value Fitting model by standard linear regression 1.2 (1.1, 1.3) 0.002 Fitting model by piecewise linear regression - - Knuckle Point (K) 25.7 - < K 1.3 (1.1, 1.6) K 0.9 (0.6, 1.2) 0.449 P for effect difference between > K and < K - 0.060 P for log-likelihood ratio test - 0.058 Figure 3 : The predictive ability of BMI for postoperative pain risk was analyzed using the ROC curve, yielding an AUC value of 0.67, 95% CI (0.60–0.74), indicating that BMI has a moderate predictive power in distinguishing the occurrence of pain, with the sensitivity and specificity of the model being 58% and 70%, respectively. Discussion Arthroscopic partial meniscectomy surgery, a minimally invasive procedure for treating meniscal injuries, is favored because of its association with minimal trauma and rapid recovery. However, postoperative pain remains a significant factor affecting patient rehabilitation and patient satisfaction with surgery. Pain can delay the patient's recovery process and increase the risk of postoperative complications [ 12 ] . Early postoperative pain can adversely affect recovery, particularly for those who are more sensitive to pain, leading to reduced patient satisfaction and limitations in knee joint function [ 6 ] . The relationship between obesity or a high body mass index (BMI) and pain involves multiple biological mechanisms. First, the chronic low-grade inflammatory state induced by obesity increases pain sensitivity through the secretion of inflammatory mediators, such as TNF-α and IL-6, by adipocytes. The levels of adipokines, particularly FGF-21, are associated with pain and stress, and an increase in these factors may promote inflammatory responses postoperatively, leading to sensitization to pain [ 13 ] . Second, obesity affects the function of immune cells, and leptin secreted by adipocytes may regulate neurotransmitters related to pain. Changes in hormone levels, such as insulin resistance and changes in sex hormones, may also affect the perception of pain [ 14 ] . A high-fat diet alters the gut microbiota, increasing the production of inflammatory mediators and thereby affecting the sensation of pain. Obesity also enhances pain by activating specific signaling pathways (such as TLR4) and proinflammatory factors (such as HMGB1) [ 15 ] . Previous studies have extensively investigated the impact of factors such as cartilage damage and meniscal injury on postoperative pain. It is believed that meniscal injuries are more common in elderly patients, who often have varying degrees of osteoarthritis, and residual osteoarthritis is an important risk factor associated with pain [ 16 ] . The occurrence of cartilage damage is related to an increased frequency of pain after anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction [ 17 ] . Additionally, patients with higher BMIs and females are more likely to experience pain after ACL and PCL reconstruction [ 18 ] . There is less research on the relationship between preoperative BMI alone and early postoperative pain. Solheim et al. reported that approximately 60% of patients experienced moderate to severe pain after arthroscopic knee surgery. A BMI of 0.30 kg/m 2 , with an OR of 2.5 and a 95% CI of 1.4–4.6, and a lateral meniscal tear, with an OR of 1.9 and a 95% CI of 1.2–2.8, were significant risk factors. This study revealed that a BMI of approximately 30 kg/m 2 was associated with unsatisfactory outcomes [ 19 ] . Our study revealed an OR of 1.23 for BMI, with a 95% CI of (1.09–1.38), and we identified 25.7 as the inflection point, which is generally in line with previous studies. However, some studies have revealed no relationship between BMI and the clinical outcomes of arthroscopic partial meniscectomy surgery in patients over 45 years old [ 20 ] . This study focused more on postoperative knee function and quality of life scores as outcome variables. Our study included 221 patients in the analysis and demonstrated the correlation between preoperative BMI and early postoperative pain after arthroscopic partial meniscectomy surgery in adults. The results revealed a nonlinear relationship, especially a significant change in pain perception when BMI reached 25.7, indicating a critical threshold effect. After further adjustment for confounding variables and multivariate logistic regression, the nonlinear relationship between BMI values and early postoperative pain was revealed through curve fitting. The results of this study provide a reference for preoperative patient assessment, surgical plan formulation, postoperative pain management, and patient satisfaction. Despite providing significant insights, this study has several limitations. First, the relatively small sample size may affect the representativeness and generalizability of the results. Additionally, as a retrospective study, we cannot entirely rule out the possibility of selection bias, which could impact the reliability of the outcomes. This study considered only a subset of influencing factors, and future research should employ a larger-scale prospective design to further validate our findings and explore more variables that may affect postoperative pain to establish a more comprehensive pain assessment mechanism. In summary, this study delved into the critical role of BMI in the early management of pain following arthroscopic partial meniscectomy surgery, highlighting the importance of BMI and offering a new perspective through statistical methods. Although there are several limitations, these findings provide valuable references for clinical practice, suggesting that patient BMI should be integrated into postoperative pain management to achieve personalized pain assessment and management. This will help to increase patient satisfaction, reduce the length of hospital stays, and promote early recovery. Conclusion The present study revealed a positive correlation between increasing body mass index (BMI) and postoperative pain (VAS score), with a particularly notable change in pain perception at a BMI of 25.7, indicating a critical threshold effect. Additionally, the ROC curve analysis revealed that BMI is a moderate predictor of postoperative pain (AUC = 0.67). These findings underscore the importance of considering patients' BMI levels in preoperative assessments and postoperative pain management to devise personalized treatment and pain management plans, thereby increasing patient satisfaction after surgery. Abbreviations BMI ：Body Mass Index,APM：Arthroscopic Partial Meniscectomy,VAS：Visual Analogue Scale ROC ：Receiver Operating Characteristic,AUC：Area Under the Curve,ACL： Anterior Cruciate Ligament,PCL：Posterior Cruciate Ligament,PRP ：Platelet-Rich Plasma. Declarations Ethics approval and consent to participate All patients agreed to the use of data in the study by providing verbal informed consent. The verbal consent approval was documented in the patients’ fles, all experimental protocols and verbal consent was approved by the Ethics Committee of Meizhou People ’ s Hospital(2024-C-198). All clinical investigations were conducted in accordance with the guidelines of the Declaration of Helsinki." Consent for publication All co-authors have agreed to the submission and publication of the article. Competing interests The authors declare no competing interests associated with this manuscript. Funding NO Author Contribution S.L. (Songlang Liu) and J.S. (Jianguang Sun) conceived and designed the study.H.L. (Hongxing Liao) and Y.Y. (Yali Yang) collected and analyzed the data.J.S. drafted the manuscript, and S.L. provided critical revisions.H.L. and Y.Y. contributed to the interpretation of the results.All authors reviewed and approved the final version of the manuscript. Acknowledgement Thank for the support of the Ethics Committee of Meizhou People 's Hospital, and for the valuable contribution of patients and colleagues in the Department of Sports Medicine of Meizhou People 's Hospital. Special thanks to Professor Liu Songlang, Professor Sun Jianguang and Professor Liao Hongxing for their guidance of this study. Availability of data and material The datasets used and analysed during the current study available from the corresponding author on reasonable request. References Hutchinson ID, Moran CJ, Potter HG, Warren RF, Rodeo SA. Restoration of the meniscus: Form and function. Am J Sports Med. 2014;42:987–98. Morgan CD, Wojtys EM, Casscells CD, Casscells SW. Arthroscopic meniscal repair evaluated by second-look arthroscopy. Am J Sports Med. 1991;19:632–8. Ridley TJ, McCarthy MA, Bollier MJ, Wolf BR, Amendola A. Age differences in the prevalence of isolated medial and lateral meniscal tears in surgically treated patients. Iowa Orthop J. 2017;37:91–4. Uzun E, Misir A, Kizkapan TB, Ozcamdalli M, Akkurt S, Guney A. Arthroscopic medial meniscal repair with or without concurrent anterior cruciate ligament reconstruction: A subgroup analysis. Knee. 2018;25:109–17. Thorlund JB, Juhl CB, Roos EM, et al. Arthroscopic surgery for degenerative knee: systematic review and meta-analysis of benefits and harms. BMJ. 2015;350:h2747. Hayashi K, Kako M, Suzuki K, et al. Associations among pain catastrophizing, muscle strength, and physical performance after total knee and hip arthroplasty. World J Orthop. 2017;8:336–41. Sturm R. Increases in clinically severe obesity in the United States, 1986–2000. Arch Intern Med. 2003;163(18):2146–8. Brown WJ, Mishra G, Kenardy J, Dobson A. Relationships between body mass index and well-being in young Australian women. Int J Obes Relat Metab Disord. 2000;24(10):1360–8. Nicolay RW, Selley RS, Terry MA, Tjong VK. Body Mass Index as a risk factor for 30-Day postoperative Complications in knee, hip, and shoulder arthroscopy. Arthroscopy: J Arthroscopic Relat Surgery: Official Publication Arthrosc Association North Am Int Arthrosc Association. 2019;35(3):874–e823. Xu J, Bian F. Pain-related risk factors after arthroscopic minimally invasive treatment of meniscus injury of knee joints. Exp Ther Med. 2020;20(3):2317–24. 10.3892/etm.2020.8953 . Epub 2020 Jun 29. PMID: 32765711; PMCID: PMC7401751. Cleveland Clinic Sports Health. Predictors of successful treatment 1 year after arthroscopic partial meniscectomy: data from the OME cohort. JBJS Open Access. 2020;5(4):e190004. Solheim N, Rosseland LA, Stubhaug A. Intra-Articular morphine 5 Mg after knee arthroscopy does not produce significant pain relief when administered to patients with moderate to severe pain via an intra-articular catheter. Reg Anesth Pain Med. 2006;31:506–13. Baker JF, Wipfler K, Olave M, Pedro S, Katz P, Michaud K. Obesity, Adipokines, and Chronic and Persistent Pain in Rheumatoid Arthritis. J Pain. 2023;24(10):1813–9. 10.1016/j.jpain.2023.05.008 . Gloersen M, Steen Pettersen P, Neogi T, Jafarzadeh SR, Vistnes M, Thudium CS, Bay-Jensen AC, Sexton J, Kvien TK, Hammer HB, Haugen IK. Associations of body mass index with pain and the mediating role of inflammatory biomarkers in people with hand osteoarthritis. Arthrit Rheumatol. 2022;74:810–7. Tramullas M, Finger BC, Dinan TG. Obesity takes its toll on visceral pain: high-fat diet induces toll-like receptor 4-dependent visceral hypersensitivity. PLoS ONE. 2016;11:e0155367. Davis TR, Brady O, Dias JJ. Excision of the trapezium for osteoarthritis of the trapeziometacarpal joint: A study of the benefit of ligament reconstruction or tendon interposition. J Hand Surg Am. 2004;29:1069–77. Fok AW, Yau WP. Delay in ACL reconstruction is associated with more severe and painful meniscal and chondral injuries. Knee Surg Sports Traumatol Arthrosc. 2013;21:928–33. Dunn WR, Spindler KP, Amendola A, Andrish JT, Kaeding CC, Marx RG, McCarty EC, Parker RD, Harrell FE Jr, An AQ. Which preoperative factors, including bone bruise, are associated with knee pain/symptoms at anterior cruciate ligament reconstruction (ACLR)? A Multicenter Orthopaedic Outcomes Network (MOON) ACLR Cohort Study. Am J Sports Med. 2010;38:1778–87. Lizaur-Utrilla A, Miralles-Muñoz FA, Gonzalez-Parreño S, Lopez-Prats FA. Outcomes and Patient Satisfaction With Arthroscopic Partial Meniscectomy for Degenerative and Traumatic Tears in Middle-Aged Patients With No or Mild Osteoarthritis. Am J Sports Med. 2019;47(10):2412–9. Epub 2019 Jun 28. PMID: 31251689. Eigenraam SM, Reijman M, Bierma-Zeinstra MA, van Yperen DT, Meuffels DE. Can we predict the clinical outcome of arthroscopic partial meniscectomy? A systematic review. BMJ Open. 2017;7(11):e007836. 10.1136/bmjsports-2017-097836 . Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5779191","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":399562635,"identity":"a62db7f3-ff9c-41c3-9a9a-547296a08486","order_by":0,"name":"Songlang Liu","email":"","orcid":"","institution":"Meizhou City People's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Songlang","middleName":"","lastName":"Liu","suffix":""},{"id":399562636,"identity":"ce0be83d-035a-4a35-bf76-5d45c3980ed4","order_by":1,"name":"Hongxing Liao","email":"","orcid":"","institution":"Meizhou City People's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Hongxing","middleName":"","lastName":"Liao","suffix":""},{"id":399562637,"identity":"c56a460c-6c64-45a2-b253-e10daeb00f49","order_by":2,"name":"Yali Yang","email":"","orcid":"","institution":"Meizhou City People's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Yali","middleName":"","lastName":"Yang","suffix":""},{"id":399562638,"identity":"2fe53067-a143-4dab-9c73-cb60adf0c8c2","order_by":3,"name":"Jianguang Sun","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAzklEQVRIiWNgGAWjYHACxocfDGx4+NkbGx9+IFILs7FERZqMZM/hZmMJIrWwSfCcOWRjMCO9TYCHGPXyM3IPG0i2HeAxkHzYxiDBYCen20BAi8GNvMQHhW13eMylE9seFDAkG5sdIKRFIscYaMszHsvZie0GEgwHErcR0iI/I8dMgrftMI/BzYNtEjzEaGG4AdTCcwao5QYjkVoMzrwxBgUyj2RPIjCQDYjwi3x7jiEoKu352Y8/fPihwk6OoBZ0S0lTPgpGwSgYBaMABwAA09FCQSLrf8IAAAAASUVORK5CYII=","orcid":"","institution":"Meizhou City People's Hospital","correspondingAuthor":true,"prefix":"","firstName":"Jianguang","middleName":"","lastName":"Sun","suffix":""}],"badges":[],"createdAt":"2025-01-07 08:08:36","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5779191/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5779191/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":73518766,"identity":"007e5c6b-5fad-47f7-9afb-32c57af75681","added_by":"auto","created_at":"2025-01-10 18:03:58","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":62666,"visible":true,"origin":"","legend":"\u003cp\u003eFlow chart of patient screening\u003c/p\u003e","description":"","filename":"Picture1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-5779191/v1/b370f8c8f4cc46378d694628.jpg"},{"id":73518759,"identity":"2e152183-1a64-496b-a28d-f6db3f963a1d","added_by":"auto","created_at":"2025-01-10 18:03:58","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":23965,"visible":true,"origin":"","legend":"\u003cp\u003eCurve Fitting of BMI and Early Postoperative VAS\u003c/p\u003e","description":"","filename":"Picture2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-5779191/v1/4569854a1091583beea9d038.jpg"},{"id":73518760,"identity":"1e0c89ec-fc9c-4f3b-94e8-915c400512b5","added_by":"auto","created_at":"2025-01-10 18:03:58","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":87287,"visible":true,"origin":"","legend":"\u003cp\u003eROC Curve of the Relationship between BMI and VAS\u003c/p\u003e","description":"","filename":"Picture3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-5779191/v1/7300ff0be06eb4957c338267.jpg"},{"id":74270520,"identity":"e943522a-b0b1-4df8-ae7d-4d47ba550d55","added_by":"auto","created_at":"2025-01-20 13:46:59","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":887917,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5779191/v1/d1d8dfe2-b8c1-4757-951f-253dbc6e47fa.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Correlation between Body Mass Index (BMI) and Early Postoperative Pain in Adults Undergoing Arthroscopic Partial Meniscectomy","fulltext":[{"header":"Introduction","content":"\u003cp\u003eKnee pain is one of the most common clinical issues among adult patients, and meniscal injuries are a frequent cause of knee pain and functional impairment \u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e. In the United States, meniscal injuries are the most common knee injuries, with an annual average incidence of 66 per 100,000 people \u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e. The meniscus serves multiple crucial functions, including shock absorption, proprioception, knee joint stability, and lubrication \u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e. Arthroscopic partial meniscectomy (APM) is a common treatment modality that minimizes soft tissue damage and shortens the hospital stay, making it one of the most frequently performed orthopedic surgeries globally \u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e. However, approximately 80% of patients who undergo APM experience severe pain postoperatively, which hinders early recovery, particularly for those who are sensitive to pain, leading to poor recovery and limited knee function \u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e. Most feedback from postsurgical patients is centered on pain; severe early postoperative pain can lead to decreased patient compliance, lower satisfaction, delayed ambulation and rehabilitation, increased hospital costs, and prolonged hospital stays. Therefore, exploring the causes of early postoperative pain in adults following APM is beneficial for improving patient satisfaction postoperatively, reducing the length of hospital stays, and facilitating early patient approval.\u003c/p\u003e \u003cp\u003eThe body mass index (BMI) is a globally recognized grading method for assessing the degree of obesity \u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e. Currently, the World Health Organization also uses this metric to classify obese or overweight individuals. Obesity is believed to exacerbate chronic pain through various mechanisms, including increasing mechanical and metabolic stress and promoting the activation of inflammatory pathways \u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e. When pain-related risk factors are evaluated in adult patients after knee meniscal reshaping surgery, diabetes and BMI are risk factors that affect patient satisfaction and readmission after all arthroscopy examinations \u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e. Compared with average patients, many patients with higher BMIs experience more severe postoperative pain and require larger doses of analgesic medication. Previous studies have mostly explored the impact of preoperative cartilage damage, age, and the choice of surgical method on postoperative pain after arthroscopic partial meniscectomy, including WOMAC scores, articular cartilage damage, weight-bearing time\u0026thinsp;\u0026lt;\u0026thinsp;1 week postoperatively, lack of cold compresses postoperatively, and open knee surgery as independent risk factors for postoperative pain \u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e. Some studies also consider BMI as a factor influencing arthroscopy \u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/sup\u003e. However, research on the correlation between preoperative BMI and early postoperative pain after knee meniscal reshaping surgery is lacking in the literature. This study focused on the relationship between preoperative BMI and early postoperative pain in adults after arthroscopic partial meniscectomy, with the aim of selecting appropriate treatment plans preoperatively, formulating individualized pain management, increasing patient satisfaction postoperatively, and including BMI as an important indicator in postoperative follow-up. This approach provides individualized exercise plans in later life to delay the onset of knee arthritis.\u003c/p\u003e"},{"header":"Materials and Statistical Methods","content":"\u003cp\u003eWe extracted data from the hospital medical records database for 530 adult patients who underwent arthroscopic partial meniscectomy surgery in 2023, with a follow-up of 4 weeks postoperatively, via the visual analog scale (VAS) score. We defined a score of 0\u0026ndash;4 as mild pain and a VAS score of 5 or above as moderate to severe pain. Ultimately, 221 patients were included in the study, with 120 patients experiencing mild pain and 101 patients experiencing moderate to severe pain. The inclusion criteria were as follows: (1) patients aged 18 years or above who underwent arthroscopic partial meniscectomy surgery; (2) patients with complete and accessible data on age, sex, disease duration, preoperative magnetic resonance imaging (MRI) assessment of cartilage damage, meniscal injury grade, and 4-week postoperative visual analog scale (VAS) score; (3) unilateral surgery; and (4) patient and family consent to use clinical data for research purposes. The exclusion criteria were as follows: (1) suspected preoperative knee joint infection, tuberculosis, or nonpure meniscal injuries or knee arthritis; (2) intraoperative procedures other than meniscal reshaping, such as platelet-rich plasma (PRP) injections into the joint cavity; (3) bilateral knee arthroscopic partial meniscectomy surgery; and (4) more than 10% missing data. See Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e This study was supported by the Ethics Committee of Meizhou People's Hospital in Guangdong Province, China, (2024-C-198)and all procedures conducted in this study were in accordance with the Declaration of Helsinki in 1964.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Indicators:\u003c/h2\u003e \u003cp\u003eThe determination of study indicators is typically based on previous literature, statistically significant indicators, or clinical significance. This study included a total of seven indicators: age (years), sex (male, female), BMI (kg/m\u003csup\u003e2\u003c/sup\u003e), disease duration (months), knee joint (left, right), degree of preoperative cartilage damage (Outerbridge grading, where grades 0\u0026ndash;2 are defined as mild cartilage damage and grades 3\u0026ndash;4 are defined as moderate to severe cartilage damage), meniscal injury grading from I to IV, and the outcome variable, the VAS score at 4 weeks postoperatively, where a VAS score of 0\u0026ndash;4 is defined as mild pain and a VAS score of 5 or above is defined as moderate to severe pain.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStatistical Methods:\u003c/h3\u003e\n\u003cp\u003eData were analyzed via SPSS 25.0, EmpowerStats, and R language 4.1.2 statistical software. Quantitative data that conformed to a normal distribution are expressed as the mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation, and comparisons between two groups were made via independent samples t tests. Quantitative data that did not conform to a normal distribution are expressed as the median (25%-75%), and comparisons between two groups were made via the Mann‒Whitney U test. Categorical data are expressed as the number of cases, and comparisons between groups were made via chi-square tests or nonparametric rank sum tests. Univariate and multivariate logistic regression analyses were conducted, with statistically significant factors included for stratified analysis to obtain threshold effects. A fitted curve between BMI and postoperative VAS score was plotted, and the receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to assess the model's discriminative ability and calibration, visualizing the relationship between BMI and postoperative VAS score.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe demographic and preoperative imaging data included age (years), sex (male, female), BMI (kg/m\u003csup\u003e2\u003c/sup\u003e), disease duration (months), knee joint (left, right), degree of preoperative cartilage damage (mild, moderate to severe), meniscal injury grade (I-III), and early postoperative VAS score (mild pain, moderate to severe pain). Statistical analysis revealed that BMI had a P value less than 0.05, which was statistically significant, whereas the P values for sex, affected leg side, meniscal injury grade, and degree of cartilage damage were all greater than 0.05, indicating no significant difference. See Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e for details.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of general data between two groups of patients\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMild Pain(n\u0026thinsp;=\u0026thinsp;120)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003emoderate to severe\u003c/p\u003e \u003cp\u003epain (n\u0026thinsp;=\u0026thinsp;101)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge(years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61.77\u0026thinsp;\u0026plusmn;\u0026thinsp;11.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e61.41\u0026thinsp;\u0026plusmn;\u0026thinsp;9.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.796\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI(kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23.81\u0026thinsp;\u0026plusmn;\u0026thinsp;2.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24.89\u0026thinsp;\u0026plusmn;\u0026thinsp;2.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCourse of disease (months)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12.72\u0026thinsp;\u0026plusmn;\u0026thinsp;21.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18.81\u0026thinsp;\u0026plusmn;\u0026thinsp;29.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.078\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex, n(%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.336\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29 (24.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19 (18.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e91 (75.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e82 (81.19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKnee joint (n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.844\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLeft\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e59 (49.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51 (50.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61 (50.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50 (49.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCartilage injury n(%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.382\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSlight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35 (29.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35 (34.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGravity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e85 (70.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e66 (65.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMeniscus, n(%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.108\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGrade I\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (0.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (5.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGrade II\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27 (22.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21 (20.79)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGradeIII\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e92 (76.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e74 (73.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThrough logistic regression models, we assessed the impact of various variables on early postoperative pain (VAS scores) following arthroscopic partial meniscectomy surgery. The logistic regression analysis results indicated that BMI was significantly associated with postoperative pain (odds ratio (OR), 1.23; 95% confidence interval (CI), 1.09\u0026ndash;1.38; P\u0026thinsp;\u0026lt;\u0026thinsp;0.01), suggesting that an increase in BMI could be an important factor for moderate-to-severe pain. The impact of meniscal injury grade III was nearly significant (P\u0026thinsp;=\u0026thinsp;0.049), indicating that a longer disease duration is associated with increased postoperative pain. However, sex, affected knee side, and other factors did not significantly differ, suggesting that these variables may have a limited role in the pathophysiological mechanisms of postoperative pain, as shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eUnivariate Analysis and Multivariate Analysis\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"11\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003eUnivariate Analysis\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c11\" namest=\"c7\"\u003e \u003cp\u003eMultivariate Analysis\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eβ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eS.E\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eZ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOR (95%CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eβ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eS.E\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eZ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003eOR (95%CI)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.337\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.38 (0.72\u0026ndash;2.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.526\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e1.25 (0.63\u0026ndash;2.48)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKnee joint\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLeft\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.844\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.95 (0.56\u0026ndash;1.61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-0.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-0.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.590\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.86 (0.49\u0026ndash;1.51)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCartilage injury n(%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSlight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGravity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.383\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.78 (0.44\u0026ndash;1.37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-0.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-0.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.502\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.79 (0.41\u0026ndash;1.55)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMeniscus, n(%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGrade I\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGrade II\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-2.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-1.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.068\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.13 (0.01\u0026ndash;1.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-2.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-1.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.061\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.11 (0.01\u0026ndash;1.10)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGradeIII\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-2.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-1.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.065\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.13 (0.02\u0026ndash;1.14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-2.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-1.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.049\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.10 (0.01\u0026ndash;0.99)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge(years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.799\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.00 (0.97\u0026ndash;1.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-0.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.810\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e1.00 (0.97\u0026ndash;1.03)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI(kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.19 (1.07\u0026ndash;1.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e3.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e1.23 (1.09\u0026ndash;1.38)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCourse of disease (months)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.086\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.01 (1.00\u0026ndash;1.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.331\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e1.01 (0.99\u0026ndash;1.02)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eBMI was divided into three levels, low, medium, and high, as follows: 16.94\u0026ndash;23.12; 23.24\u0026ndash;25.67; and 25.71\u0026ndash;30.94 (kg/m\u003csup\u003e2\u003c/sup\u003e), to observe the impact of each BMI level and adjusted variables on the postoperative VAS score. The results of the unadjusted model revealed that for each unit increase in BMI, the likelihood of early postoperative pain increased by 20%, OR\u0026thinsp;=\u0026thinsp;1.2, 95% CI (1.1\u0026ndash;1.3), P\u0026thinsp;=\u0026thinsp;0.0020. In Model I, after adjusting for sex, the relationship between BMI and postoperative pain remained significant (OR\u0026thinsp;=\u0026thinsp;1.2, 95% CI (1.1\u0026ndash;1.4), P\u0026thinsp;=\u0026thinsp;0.0010). After further adjustment for sex, age, affected knee, degree of cartilage damage, degree of meniscal damage, and disease duration in Model II, the relationship between BMI and postoperative pain remained robust (OR\u0026thinsp;=\u0026thinsp;1.2, 95% CI (1.1\u0026ndash;1.4), P\u0026thinsp;=\u0026thinsp;0.0028). In the stratified analysis of BMI, a medium BMI was significantly associated with postoperative pain in adjusted Model I (OR\u0026thinsp;=\u0026thinsp;2.1, 95% CI (1.0-4.3), P\u0026thinsp;=\u0026thinsp;0.0362), whereas a high BMI was significantly associated with pain in all the models, especially in adjusted Model II (OR\u0026thinsp;=\u0026thinsp;2.5, 95% CI (1.2\u0026ndash;5.1), P\u0026thinsp;=\u0026thinsp;0.0142). These results emphasize the correlation between BMI and early postoperative pain after arthroscopic partial meniscectomy surgery (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultivariate Regression Analysis\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNon-adjusted\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAdjust I\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdjust II\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.2 (1.1, 1.3) 0.0020\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.2 (1.1, 1.4) 0.0010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.2 (1.1, 1.4) 0.0028\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI Tertile\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMiddle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.8 (0.9, 3.5) 0.0819\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.1 (1.0, 4.3) 0.0362\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.0 (1.0, 4.1) 0.0555\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.4 (1.3, 4.7) 0.0087\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.7 (1.3, 5.5) 0.0062\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.5 (1.2, 5.1) 0.0142\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e Data: OR (95% CI) P-value, Outcome Variable: VAS, Exposure Variable: BMI; Minimum adjustment model adjusted for gender, Full adjustment model adjusted for gender, age, knee, meniscal injury, disease duration, and degree of cartilage damage.\u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e illustrates the curve fitting between BMI and pain after arthroscopic partial meniscectomy surgery, further revealing the nonlinear relationship between BMI and pain risk and providing a visual representation. Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e shows the threshold effect of BMI on early postoperative VAS score, characterized by a clear inflection point at BMI\u0026thinsp;=\u0026thinsp;25.7. Below this inflection point, the OR was 1.3, with a 95% CI (1.1, 1.6) and P\u0026thinsp;\u0026lt;\u0026thinsp;0.01, indicating that the VAS score significantly increased with increasing BMI, indicating a strong positive correlation. However, when the BMI exceeds 25.7, the OR is 0.9, with a 95% CI (0.6, 1.2) and P\u0026thinsp;=\u0026thinsp;0.049, indicating that the increase in the VAS score is no longer significant.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThreshold Effect\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOutcome\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFitting model by standard linear regression\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.2 (1.1, 1.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFitting model by piecewise linear regression\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKnuckle Point (K)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt; K\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.3 (1.1, 1.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt; K\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.9 (0.6, 1.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.449\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP for effect difference between \u0026gt;\u0026thinsp;K and \u0026lt;\u0026thinsp;K\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.060\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP for log-likelihood ratio test\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.058\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e: The predictive ability of BMI for postoperative pain risk was analyzed using the ROC curve, yielding an AUC value of 0.67, 95% CI (0.60\u0026ndash;0.74), indicating that BMI has a moderate predictive power in distinguishing the occurrence of pain, with the sensitivity and specificity of the model being 58% and 70%, respectively.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eArthroscopic partial meniscectomy surgery, a minimally invasive procedure for treating meniscal injuries, is favored because of its association with minimal trauma and rapid recovery. However, postoperative pain remains a significant factor affecting patient rehabilitation and patient satisfaction with surgery. Pain can delay the patient's recovery process and increase the risk of postoperative complications \u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e. Early postoperative pain can adversely affect recovery, particularly for those who are more sensitive to pain, leading to reduced patient satisfaction and limitations in knee joint function \u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe relationship between obesity or a high body mass index (BMI) and pain involves multiple biological mechanisms. First, the chronic low-grade inflammatory state induced by obesity increases pain sensitivity through the secretion of inflammatory mediators, such as TNF-α and IL-6, by adipocytes. The levels of adipokines, particularly FGF-21, are associated with pain and stress, and an increase in these factors may promote inflammatory responses postoperatively, leading to sensitization to pain \u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e. Second, obesity affects the function of immune cells, and leptin secreted by adipocytes may regulate neurotransmitters related to pain. Changes in hormone levels, such as insulin resistance and changes in sex hormones, may also affect the perception of pain \u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e. A high-fat diet alters the gut microbiota, increasing the production of inflammatory mediators and thereby affecting the sensation of pain. Obesity also enhances pain by activating specific signaling pathways (such as TLR4) and proinflammatory factors (such as HMGB1) \u003csup\u003e[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003ePrevious studies have extensively investigated the impact of factors such as cartilage damage and meniscal injury on postoperative pain. It is believed that meniscal injuries are more common in elderly patients, who often have varying degrees of osteoarthritis, and residual osteoarthritis is an important risk factor associated with pain \u003csup\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e. The occurrence of cartilage damage is related to an increased frequency of pain after anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction \u003csup\u003e[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e. Additionally, patients with higher BMIs and females are more likely to experience pain after ACL and PCL reconstruction \u003csup\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/sup\u003e. There is less research on the relationship between preoperative BMI alone and early postoperative pain.\u003c/p\u003e \u003cp\u003eSolheim et al. reported that approximately 60% of patients experienced moderate to severe pain after arthroscopic knee surgery. A BMI of 0.30 kg/m\u003csup\u003e2\u003c/sup\u003e, with an OR of 2.5 and a 95% CI of 1.4\u0026ndash;4.6, and a lateral meniscal tear, with an OR of 1.9 and a 95% CI of 1.2\u0026ndash;2.8, were significant risk factors. This study revealed that a BMI of approximately 30 kg/m\u003csup\u003e2\u003c/sup\u003e was associated with unsatisfactory outcomes \u003csup\u003e[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/sup\u003e. Our study revealed an OR of 1.23 for BMI, with a 95% CI of (1.09\u0026ndash;1.38), and we identified 25.7 as the inflection point, which is generally in line with previous studies. However, some studies have revealed no relationship between BMI and the clinical outcomes of arthroscopic partial meniscectomy surgery in patients over 45 years old \u003csup\u003e[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/sup\u003e. This study focused more on postoperative knee function and quality of life scores as outcome variables. Our study included 221 patients in the analysis and demonstrated the correlation between preoperative BMI and early postoperative pain after arthroscopic partial meniscectomy surgery in adults. The results revealed a nonlinear relationship, especially a significant change in pain perception when BMI reached 25.7, indicating a critical threshold effect. After further adjustment for confounding variables and multivariate logistic regression, the nonlinear relationship between BMI values and early postoperative pain was revealed through curve fitting. The results of this study provide a reference for preoperative patient assessment, surgical plan formulation, postoperative pain management, and patient satisfaction.\u003c/p\u003e \u003cp\u003eDespite providing significant insights, this study has several limitations. First, the relatively small sample size may affect the representativeness and generalizability of the results. Additionally, as a retrospective study, we cannot entirely rule out the possibility of selection bias, which could impact the reliability of the outcomes. This study considered only a subset of influencing factors, and future research should employ a larger-scale prospective design to further validate our findings and explore more variables that may affect postoperative pain to establish a more comprehensive pain assessment mechanism.\u003c/p\u003e \u003cp\u003eIn summary, this study delved into the critical role of BMI in the early management of pain following arthroscopic partial meniscectomy surgery, highlighting the importance of BMI and offering a new perspective through statistical methods. Although there are several limitations, these findings provide valuable references for clinical practice, suggesting that patient BMI should be integrated into postoperative pain management to achieve personalized pain assessment and management. This will help to increase patient satisfaction, reduce the length of hospital stays, and promote early recovery.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe present study revealed a positive correlation between increasing body mass index (BMI) and postoperative pain (VAS score), with a particularly notable change in pain perception at a BMI of 25.7, indicating a critical threshold effect. Additionally, the ROC curve analysis revealed that BMI is a moderate predictor of postoperative pain (AUC\u0026thinsp;=\u0026thinsp;0.67). These findings underscore the importance of considering patients' BMI levels in preoperative assessments and postoperative pain management to devise personalized treatment and pain management plans, thereby increasing patient satisfaction after surgery.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eBMI\u0026nbsp;：Body Mass Index,APM：Arthroscopic Partial Meniscectomy,VAS：Visual Analogue Scale\u003c/p\u003e\n\u003cp\u003eROC\u0026nbsp;：Receiver Operating Characteristic,AUC：Area Under the Curve,ACL：\u0026nbsp;Anterior Cruciate Ligament,PCL：Posterior Cruciate Ligament,PRP\u0026nbsp;：Platelet-Rich Plasma.\u003c/p\u003e"},{"header":"Declarations","content":" \u003cp\u003e \u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e \u003cp\u003e All patients agreed to the use of data in the study by providing verbal informed consent. The verbal consent approval was documented in the patients\u0026rsquo; fles, all experimental protocols and verbal consent was approved by the Ethics Committee of Meizhou People \u0026rsquo; s Hospital(2024-C-198). All clinical investigations were conducted in accordance with the guidelines of the Declaration of Helsinki.\"\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eConsent for publication\u003c/strong\u003e \u003cp\u003e All co-authors have agreed to the submission and publication of the article.\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eCompeting interests\u003c/h2\u003e \u003cp\u003eThe authors declare no competing interests associated with this manuscript.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eNO\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eS.L. (Songlang Liu) and J.S. (Jianguang Sun) conceived and designed the study.H.L. (Hongxing Liao) and Y.Y. (Yali Yang) collected and analyzed the data.J.S. drafted the manuscript, and S.L. provided critical revisions.H.L. and Y.Y. contributed to the interpretation of the results.All authors reviewed and approved the final version of the manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eThank for the support of the Ethics Committee of Meizhou People 's Hospital, and for the valuable contribution of patients and colleagues in the Department of Sports Medicine of Meizhou People 's Hospital. Special thanks to Professor Liu Songlang, Professor Sun Jianguang and Professor Liao Hongxing for their guidance of this study.\u003c/p\u003e\u003ch2\u003eAvailability of data and material\u003c/h2\u003e \u003cp\u003eThe datasets used and analysed during the current study available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eHutchinson ID, Moran CJ, Potter HG, Warren RF, Rodeo SA. Restoration of the meniscus: Form and function. Am J Sports Med. 2014;42:987\u0026ndash;98.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMorgan CD, Wojtys EM, Casscells CD, Casscells SW. Arthroscopic meniscal repair evaluated by second-look arthroscopy. Am J Sports Med. 1991;19:632\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRidley TJ, McCarthy MA, Bollier MJ, Wolf BR, Amendola A. Age differences in the prevalence of isolated medial and lateral meniscal tears in surgically treated patients. Iowa Orthop J. 2017;37:91\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUzun E, Misir A, Kizkapan TB, Ozcamdalli M, Akkurt S, Guney A. Arthroscopic medial meniscal repair with or without concurrent anterior cruciate ligament reconstruction: A subgroup analysis. Knee. 2018;25:109\u0026ndash;17.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eThorlund JB, Juhl CB, Roos EM, et al. Arthroscopic surgery for degenerative knee: systematic review and meta-analysis of benefits and harms. BMJ. 2015;350:h2747.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHayashi K, Kako M, Suzuki K, et al. Associations among pain catastrophizing, muscle strength, and physical performance after total knee and hip arthroplasty. World J Orthop. 2017;8:336\u0026ndash;41.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSturm R. Increases in clinically severe obesity in the United States, 1986\u0026ndash;2000. Arch Intern Med. 2003;163(18):2146\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBrown WJ, Mishra G, Kenardy J, Dobson A. Relationships between body mass index and well-being in young Australian women. Int J Obes Relat Metab Disord. 2000;24(10):1360\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNicolay RW, Selley RS, Terry MA, Tjong VK. Body Mass Index as a risk factor for 30-Day postoperative Complications in knee, hip, and shoulder arthroscopy. Arthroscopy: J Arthroscopic Relat Surgery: Official Publication Arthrosc Association North Am Int Arthrosc Association. 2019;35(3):874\u0026ndash;e823.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eXu J, Bian F. Pain-related risk factors after arthroscopic minimally invasive treatment of meniscus injury of knee joints. Exp Ther Med. 2020;20(3):2317\u0026ndash;24. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3892/etm.2020.8953\u003c/span\u003e\u003cspan address=\"10.3892/etm.2020.8953\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2020 Jun 29. PMID: 32765711; PMCID: PMC7401751.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCleveland Clinic Sports Health. Predictors of successful treatment 1 year after arthroscopic partial meniscectomy: data from the OME cohort. JBJS Open Access. 2020;5(4):e190004.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSolheim N, Rosseland LA, Stubhaug A. Intra-Articular morphine 5 Mg after knee arthroscopy does not produce significant pain relief when administered to patients with moderate to severe pain via an intra-articular catheter. Reg Anesth Pain Med. 2006;31:506\u0026ndash;13.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBaker JF, Wipfler K, Olave M, Pedro S, Katz P, Michaud K. Obesity, Adipokines, and Chronic and Persistent Pain in Rheumatoid Arthritis. J Pain. 2023;24(10):1813\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jpain.2023.05.008\u003c/span\u003e\u003cspan address=\"10.1016/j.jpain.2023.05.008\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGloersen M, Steen Pettersen P, Neogi T, Jafarzadeh SR, Vistnes M, Thudium CS, Bay-Jensen AC, Sexton J, Kvien TK, Hammer HB, Haugen IK. Associations of body mass index with pain and the mediating role of inflammatory biomarkers in people with hand osteoarthritis. Arthrit Rheumatol. 2022;74:810\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTramullas M, Finger BC, Dinan TG. Obesity takes its toll on visceral pain: high-fat diet induces toll-like receptor 4-dependent visceral hypersensitivity. PLoS ONE. 2016;11:e0155367.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDavis TR, Brady O, Dias JJ. Excision of the trapezium for osteoarthritis of the trapeziometacarpal joint: A study of the benefit of ligament reconstruction or tendon interposition. J Hand Surg Am. 2004;29:1069\u0026ndash;77.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFok AW, Yau WP. Delay in ACL reconstruction is associated with more severe and painful meniscal and chondral injuries. Knee Surg Sports Traumatol Arthrosc. 2013;21:928\u0026ndash;33.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDunn WR, Spindler KP, Amendola A, Andrish JT, Kaeding CC, Marx RG, McCarty EC, Parker RD, Harrell FE Jr, An AQ. Which preoperative factors, including bone bruise, are associated with knee pain/symptoms at anterior cruciate ligament reconstruction (ACLR)? A Multicenter Orthopaedic Outcomes Network (MOON) ACLR Cohort Study. Am J Sports Med. 2010;38:1778\u0026ndash;87.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLizaur-Utrilla A, Miralles-Mu\u0026ntilde;oz FA, Gonzalez-Parre\u0026ntilde;o S, Lopez-Prats FA. Outcomes and Patient Satisfaction With Arthroscopic Partial Meniscectomy for Degenerative and Traumatic Tears in Middle-Aged Patients With No or Mild Osteoarthritis. Am J Sports Med. 2019;47(10):2412\u0026ndash;9. Epub 2019 Jun 28. PMID: 31251689.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEigenraam SM, Reijman M, Bierma-Zeinstra MA, van Yperen DT, Meuffels DE. Can we predict the clinical outcome of arthroscopic partial meniscectomy? A systematic review. BMJ Open. 2017;7(11):e007836. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1136/bmjsports-2017-097836\u003c/span\u003e\u003cspan address=\"10.1136/bmjsports-2017-097836\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Body Mass Index (BMI), Arthroscopic Partial Meniscectomy, Visual Analogue Scale(VAS)","lastPublishedDoi":"10.21203/rs.3.rs-5779191/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5779191/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eArthroscopic partial meniscectomy surgery has become a common treatment for meniscal injuries; however, early postoperative pain significantly affects patient satisfaction with this surgery. Previous studies have largely explored the differences between arthroscopic partial meniscectomy and conservative rehabilitation, as well as factors affecting postoperative quality of life, with less focus on the relationship between the preoperative body mass index (BMI) and early postoperative pain following arthroscopic partial meniscectomy. This study is based on early feedback from patients after arthroscopic meniscal repair surgery, where the primary concern is early postoperative pain, to analyze the correlation between preoperative BMI and early postoperative pain after arthroscopic meniscal repair in adults.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eWe retrospectively analyzed clinical data from 221 adult patients who underwent arthroscopic partial meniscectomy at Meizhou People's Hospital, Guangdong Province, China, in 2023. Univariate and multivariate logistic regression analyses, stratified analysis, and threshold effect assessment were employed to evaluate the impact of preoperative BMI, age, sex, disease duration, cartilage injury severity, and meniscal injury grade on postoperative pain. A fitted curve between BMI and postoperative visual analog scale (VAS) score was plotted to visualize the correlation, and the model's efficacy was analyzed via receiver operating characteristic (ROC) curves.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eAfter adjusting for confounding factors through univariate and multivariate analyses, preoperative BMI (\u003cb\u003eβ\u003c/b\u003e\u0026thinsp;=\u0026thinsp;0.20, P\u0026thinsp;\u0026lt;\u0026thinsp;0.01), with an odds ratio of 1.23 and a 95% confidence interval of 1.09\u0026ndash;1.38, was identified as a significant factor influencing early postoperative pain. The relationship between the two variables was nonlinear, with a threshold effect revealing BMI\u0026thinsp;=\u0026thinsp;25.7 as a critical inflection point, where pain significantly changed. The ROC curve analysis indicated that BMI has moderate predictive power for postoperative pain risk (AUC\u0026thinsp;=\u0026thinsp;0.67).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eA significant correlation exists between preoperative BMI and early postoperative pain following arthroscopic partial meniscectomy, with a nonlinear relationship and a key inflection point at BMI\u0026thinsp;=\u0026thinsp;25.7. This finding can aid in the creation of personalized treatment, management and rehabilitation plans, thus improving patient satisfaction after surgery.\u003c/p\u003e","manuscriptTitle":"Correlation between Body Mass Index (BMI) and Early Postoperative Pain in Adults Undergoing Arthroscopic Partial Meniscectomy","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-01-10 18:03:53","doi":"10.21203/rs.3.rs-5779191/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c2a9d1b8-eaba-462a-b8bd-9015ae473713","owner":[],"postedDate":"January 10th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-03-04T04:38:22+00:00","versionOfRecord":[],"versionCreatedAt":"2025-01-10 18:03:53","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5779191","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5779191","identity":"rs-5779191","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}