Impact of BMI on two-year clinical outcomes following surgical treatment of insertional achilles tendinopathy.

INTRODUCTION: Higher body mass index (BMI) may increase complications and poor outcomes surgery for insertional Achilles tendinopathy (IAT) but its exact impact remains unclear. METHODS: A retrospective review of 75 unilateral IAT surgery patients was performed, and patients were categorised into normal (< 30 kg/m2, n = 47) and obese BMI (≥ 30 kg/m2, n = 28) groups. Clinical outcomes were assessed preoperatively, at 6-months and 2-years postoperatively using AOFAS hindfoot, VAS pain, SF-36 physical and mental scores, and patient satisfaction. RESULTS: Both groups showed significant improvement in all measures with no significant differences between the two groups. Both groups achieved similar final postoperative scores at 2 years. Wound complications were higher in the obese group (n = 2 vs 1, 7.1% vs 2.1%) but was not statistically significant (p = 0.284). Postoperative satisfaction (p = 0.394) was comparable. CONCLUSION: Obese patients can achieve outcomes comparable to those with normal BMI following IAT surgery. LEVELS OF EVIDENCE: Level III, retrospective cohort study.