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Obesity causes poorer clinical results and higher re-tear rates in rotator cuff repair

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Abstract

Background

The purpose of this retrospective study was to report on the functional outcome after both open and arthroscopic rotator cuff (RC) repair in normal weight, pre-obese and obese patients. It was hypothesized that obesity is a negative prognostic factor for clinical outcome and failure for the RC repair.

Methods

One hundred and forty-six patients who underwent either open or arthroscopic rotator cuff repair between 2006 and 2010 were included in this study. Seventy-five patients (56.7 ± 10.1 years of age) after open RC repair and 71 patients (59.0 ± 9.1 years of age) treated arthroscopically were available for evaluation. In both groups a double-row reconstruction was performed. Patients were divided in three groups according to their body-mass index. The mean follow-up was at 43 ± 16 (minimum 24) months. At follow-up, the clinical outcome was assessed by the DASH and Constant score. An ultrasound of both shoulders was performed in all patients.

Results

The mean BMI was 28.3 ± 5.3 in the arthroscopic group and 27.7 ± 4.3 in the open group. Overall, in both groups similar clinical results were noted [Constant–Murley score 78.3 ± 18.2 arthroscopic vs. 77.0 ± 21.8 for open surgery; DASH 12.7 ± 18.2 arthroscopic vs. 15.6 ± 21.6 for open surgery (p = 0.81)]. Both the failure rate and the clinical outcome were significantly worse for obese patients (BMI > 30, p = 0.007). The failure rate was 15.8% for the normal-weight patients, 8.2% in the pre-obese group and in the obese group 28.6%. The RC repair failure occurred in 11 cases in both groups after arthroscopic or open treatment (15.0%).

Conclusions

Both the arthroscopic and the open approach showed equivalent clinical results and failure rates. Obesity (BMI > 30) causes less favorable results in the Constant and DASH scores and showed higher re-tear rates.

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Authors and Affiliations

  1. BG Trauma Center Tübingen, Eberhard-Karls-Universität Tübingen, Schnarrenbergstr. 95, 72076, Tübingen, Germany

    A. Ateschrang, F. Eggensperger, M. D. Ahrend, S. Schröter, U. Stöckle & Tobias M. Kraus

  2. AO Research Institute, Clavadelerstrasse 8, 7270, Davos, Switzerland

    M. D. Ahrend

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  1. A. Ateschrang
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  2. F. Eggensperger
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Correspondence to Tobias M. Kraus.

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Ateschrang, A., Eggensperger, F., Ahrend, M.D. et al. Obesity causes poorer clinical results and higher re-tear rates in rotator cuff repair. Arch Orthop Trauma Surg 138, 835–842 (2018). https://doi.org/10.1007/s00402-018-2921-1

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  • DOI: https://doi.org/10.1007/s00402-018-2921-1

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