A new study published in the August 2017 issue of The American Journal of Sports Medicine suggests that patients with gout have an increased risk of receiving rotator cuff tear repair surgery.
Gout Increases Risk of Rotator Cuff Repair
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Secondary
Not many clinical epidemiological studies have been conducted on gout’s effect on tendons so Shih-Wei Huang, M.D, of the department of Physical Medicine & Rehabilitation at Shuang Ho Hospital and Taipei Medical University in Taipei, Taiwan, and colleagues investigated the relationships between gout and rotator cuff tear repair surgery.
The researchers used seven-year longitudinal follow-up data from patients from the Taiwan Longitudinal Health Insurance Database 2005. The study included 32,723 patients with gout and 65,446 people matched by propensity scores.
According to the data, the incidence of rotator cuff repair was 31 and 18 per 100,000 person-years in the gout and control cohorts, respectively. And the adjusted Hazard Ratio (HR) was 1.73 (95% of CI, 1.20-2.50, P < .001) among patients with gout who did not take hypouricemic medication and 2.70 (95% of CI, 1.31-5.59; P < .01) for patients with gout aged 50 years or younger.
The researchers wrote, “Patients with gout, particularly those aged 50 years or younger and without hypouricemic medication control, are at a relatively higher risk of receiving rotator cuff repair surgery.”
They also suggested that better control of uric acid levels with hypouricemic medication may reduce the risk of rotator cuff repair.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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