Outcomes of arthroscopic rotator cuff repairs in obese patients

• Published in: Journal of shoulder and elbow surgery 2011-09, Vol.20 (6), p.961-967
• Main Authors: Warrender, William J., BS, Brown, Ouida L., MD, Abboud, Joseph A., MD
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Arthroscopy; Biological and medical sciences; Diseases of the osteoarticular system; Endoscopy; Female; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Metabolic diseases; Middle Aged; Obesity; Obesity - complications; Orthopedics; Retrospective Studies; Rotator Cuff - surgery; Rotator Cuff Injuries; rotator cuff repair; Shoulder; Tendon Injuries - complications; Tendon Injuries - surgery; Treatment Outcome; Young Adult
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2010.11.006

Hypothesis Rotator cuff tears are common orthopedic injuries and their arthroscopic treatment can be technically challenging. This study evaluated the outcomes of arthroscopic rotator cuff repairs in obese patients. We hypothesized that there would be a direct correlation between worse outcomes of arthroscopic rotator cuff repairs and increasing body mass index (BMI). Materials and methods A retrospective review of patients undergoing arthroscopic rotator cuff repair by one orthopedic surgeon between 2005 and 2008 was performed. The study included 149 rotator cuff repairs. Recorded data included age, sex, BMI, size of rotator cuff tear on magnetic resonance imaging and intraoperatively, number of anchors used for repair, functional outcomes (American Shoulder and Elbow Surgeons and University of Pennsylvania scores), surgery time, total time for anesthesia, positioning, and hospital stay. Tears were classified by size. Strict inclusion and exclusion criteria were used. Surgical procedures were performed with general anesthesia, interscalene block, beach chair positioning, and a standardized operative technique. Patients followed a standard postoperative rehabilitation protocol. Results Mean patient age was 66 years. Mean follow-up was 16.3 months. Tears were classified as high grade partial (12%), small (23%), medium (29%), large (22%), and massive (14%). Patients were classified as normal weight (38%), overweight (23%), obese (20%), and morbidly obese (19%). A statistically significant correlation was found between obesity and worse functional outcomes, longer operative times, and longer length of hospital stay. Discussion This study reports new data concerning the association of BMI and early clinical outcome after arthroscopic rotator cuff repair surgery. Even though the obese group had greater limiations and lower rates of satisfaction at final follow-up than their non-obese counterparts, they still reported significant improvements from the surgery. Conclusion Obesity has a negative impact on the operative time of arthroscopic rotator cuff repairs, length of hospitalization, and functional outcomes.