Severely Obese Patients Do Well After Rotator Cuff Repair

Patients with severe obesity can still achieve excellent functional outcomes after arthroscopic rotator cuff repair, according to a new study.

The study, “Severe Obesity Is Not Associated With Worse Functional Outcomes Following Arthroscopic Rotator Cuff Repair,” was published online on March 9, 2022 in the journal Arthroscopy.

“The purpose of this study is to investigate the outcomes of arthroscopic rotator cuff repair in a severely obese population (BMI > 40 kg/m²) compared to a health weight population (BMI 18.5-24.9 kg/ m²),” the researchers wrote.

The primary outcome measures analyzed included the American Shoulder and Elbow Surgeons Score, the Single Assessment Numeric Evaluation, pain Visual Analog Scale, range of motion, and complications.

The study included 89 patients, 52 healthy weight and 37 severely obese. Overall, patient reported pain and functional outcomes improved in both groups including Visual Analog Score scores, Single Assessment Numeric Evaluation scores and American Shoulder and Elbow Surgeons Shoulder scores (p < .0001).

Compared with the healthy weight group, the severely obese patients had inferior outcomes in Visual Analog Score scores (p = .0048), Single Assessment Numeric Evaluation scores (p = .0118), American Shoulder and Elbow Surgeons Shoulder scores (p < .0031), and post-operative internal rotation (p = .0132). The differences, however, were not clinically significant.

The researchers also reported that the severely obese group had higher total numbers of comorbid conditions and longer surgical times (p = .0041).

“Severely obese patients and their associated comorbid conditions pose unique challenges in rotator cuff tear management, but still achieve overall excellent outcomes after repair and non-inferior clinical differences when compared to healthy weight patients,” they wrote.

Study authors included Austin B. Fares, M.D., John P. Scanaliato, M.D., Anthony Gavalas, M.D., John C. Dunn, M.D., of Texas Tech University of the Health Sciences Center in El Paso, Texas. Hunter Czajkowski of Carthage Area Hospital in Carthage, New York, and Nata Parnes, M.D., of Carthage Area Hospital in Carthage, New York and Claxton-Hepburn Medical Center in Ogdensburg, New York, also contributed to the study.