Association of obesity with high retears, and complication rates, and low functional scores after rotator cuff repair: a systematic review and meta-analysis.

Abstract

Obesity influences the outcomes of orthopedic surgeries such as total knee arthroplasty and spinal surgery. However, the effect of obesity on the outcomes of rotator cuff repair is unknown. This systematic review and meta-analysis aimed to examine the effect of obesity on rotator cuff repair outcomes. PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched to identify relevant studies published from their inception till July 2022. Two reviewers independently screened titles and abstracts using the specified criteria. Articles were included if they indicated the effect of obesity on rotator cuff repair and the related outcomes after surgery. Review Manager (RevMan) 5.4.1 software was used to perform statistical analysis. Thirteen articles involving 85497 patients were included. Obese patients had higher retear rates than nonobese patients (OR 2.58, 95% CI 1.23-5.41, P=0.01), lower American Shoulder and Elbow Surgeons (ASES) scores (MD: -3.59, 95% CI: -5.45-[-1.74]; P=0.0001), higher visual analog scale (VAS) for pain (MD: 0.73, 95% CI: 0.29-1.17; P=0.001), higher reoperation rates (OR 1.31, 95% CI 1.21-1.42, P<0.00001), and higher rates of complications (OR 1.57, 95% CI 1.31-1.87, P=0.000). Obesity did not affect the duration of surgery (MD: 6.03, 95% CI: -7.63-19.69; P=0.39) or external rotation (ER) of the shoulder (MD: -1.79, 95% CI: -5.30-1.72; P=0.32). Obesity is a significant risk factor for retear and reoperation after rotator cuff repair. Furthermore, obesity increases the risk of postoperative complications and leads to lower postoperative ASES scores and higher shoulder VAS for pain.