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Comparable clinical and structural outcomes after arthroscopic rotator cuff repair in diabetic and non-diabetic patients

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To compare clinical outcome and rotator cuff integrity after arthroscopic rotator cuff repair (ARCR) in patients with and without diabetes mellitus.

Methods

This retrospective study involved 264 consecutive patients who underwent ARCR from 2012 to 2015. Inclusion criteria were a medium or large-sized tear and a minimum of 1-year follow-up. Clinical outcome measures included range of motion (ROM) and the Japanese Orthopaedic Association (JOA) and University of California, Los Angeles (UCLA) scores preoperatively and at final follow-up. Rotator cuff retear was evaluated with magnetic resonance imaging at 3 months post-surgery and final follow-up. Diabetic patients with poor control were pre-operatively hospitalized for intensive diabetic control.

Results

Our inclusion criteria were met by 30 diabetic patients and 126 non-diabetic patients. Demographic data were not significantly different between the groups, except body mass index (p = 0.021). Preoperative JOA and UCLA scores of the diabetic patients were significantly lower than those of the non-diabetic patients (p < 0.001, and p = 0.006, respectively); however, the scores at final follow-up were not different. ROM was significantly restricted in the diabetic patients before surgery (forward flexion, abduction, internal rotation: p < 0.001, external rotation: p = 0.035), but at the final follow-up, there was no significant difference except for internal rotation (p = 0.005). The retear rate in diabetic patients (23.3%) was not significantly different from that in non-diabetic patients (15.1%).

Conclusions

Diabetic patients who had good perioperative glycemic control showed clinical and structural outcomes comparable to non-diabetic patients after ARCR. Intensive perioperative glycemic control and patient education are recommended for preoperative uncontrolled diabetic patients.

Level of evidence

III.

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Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Yoshinogawa Medical Center, 120 Nishichiejima, Chiejima, Kamojima-cho, Yoshinogawa, Tokushima, 776-8511, Japan

    Katsutoshi Miyatake

  2. Department of Orthopaedic Surgery, Tokushima Red Cross Hospital, 103 Irinokuchi, Komatsushima-cho, Komatsushima, Tokushima, 773-8502, Japan

    Yoshitsugu Takeda, Koji Fujii, Naoto Suzue, Yoshiteru Kawasaki, Yasuyuki Omichi & Kenji Yokoyama

Authors
  1. Katsutoshi Miyatake
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  2. Yoshitsugu Takeda
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  3. Koji Fujii
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  4. Naoto Suzue
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  5. Yoshiteru Kawasaki
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  6. Yasuyuki Omichi
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Correspondence to Yoshitsugu Takeda.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Ethical committee of Tokushima Red Cross Hospital (Tokubyoso-283).

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Miyatake, K., Takeda, Y., Fujii, K. et al. Comparable clinical and structural outcomes after arthroscopic rotator cuff repair in diabetic and non-diabetic patients. Knee Surg Sports Traumatol Arthrosc 26, 3810–3817 (2018). https://doi.org/10.1007/s00167-018-4994-3

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  • DOI: https://doi.org/10.1007/s00167-018-4994-3

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