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Obesity and Reverse Total Shoulder Arthroplasty

  • Reverse Shoulder Arthroplasty (E Craig, Section Editor)
  • Published:
Current Reviews in Musculoskeletal Medicine Aims and scope Submit manuscript

Abstract

Purpose of Review

Rates of obesity and reverse total shoulder arthroplasty (rTSA) in the USA have both escalated with time. Obese patients experience arthritis at higher rates than normal weight patients; therefore, these numbers go hand in hand. Obesity has been correlated with health comorbidities such as anxiety, cardiovascular disease, diabetes, and metabolic syndrome as well as poorer outcomes and higher complication rates following lower extremity arthroplasty. The current review investigates these comorbidities as they relate to obese patients undergoing rTSA.

Recent Findings

Functional outcomes are similar to normal weight counterparts. Although longer operative times and a large soft tissue envelope would intuitively predispose these patients to higher risk for infection or other complications, this has not been reliably demonstrated. Technical considerations and awareness of potential risks in the obese patient demographic may aid the surgeon in preoperative planning and counseling of their patient.

Summary

Obese patients undergoing rTSA have been shown to have higher risks specifically for infection, revision, and medical complications; however, this has not been consistently demonstrated in the single surgeon series where, more often, no difference in these metrics has been found. Outcomes measures and satisfaction are reliably improved, even when considering superobese patients, and majority of studies find their improvements and absolute values to be in line with their normal weight counterparts. Thus, rTSA does not seem to carry the same level of adverse risk associated with lower joint arthroplasty but potential for higher risk still bears consideration when counseling obese patients. Attention to factors that may negatively affect prosthesis positioning may optimize retention rates and limit early failure.

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Authors and Affiliations

  1. Heartland Orthopedic Specialists, 111 17th Ave E, Ste 101, Alexandria, MN, 56308, USA

    Emily J. Monroe, Richard Hardy, James Holmquist & Jefferson C. Brand

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  1. Emily J. Monroe
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Correspondence to Emily J. Monroe.

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Emily Monroe, Richard Hardy, and James Holmquist declare that they have no conflict of interest. Jefferson Brand is Assistant Editor-in-Chief of Arthroscopy Journal as employee of Arthroscopy Association of North America.

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Monroe, E.J., Hardy, R., Holmquist, J. et al. Obesity and Reverse Total Shoulder Arthroplasty. Curr Rev Musculoskelet Med 15, 180–186 (2022). https://doi.org/10.1007/s12178-022-09753-8

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