Abstract
Diabetes has been postulated to be a risk factor for both rotator cuff (RC) tears and poorer functional outcomes after rotator cuff repair (RCR) surgery. The purpose of this review is to explore and better understand the role of diabetes on functional outcomes and retear rates after RCR surgery. Population based studies have shown that diabetes acts as an independent risk factor for RC tears and RCR surgery. The two prevailing hypothesis on this subject, the local and systemic hypothesis, propose that diabetes, through a variety of pathways, acts to reduce tendon quality and disrupts tendon architecture. This leads to a lower load to failure of the cuff tendons and a poorer healing response to the tear itself. Animal and lab-based studies have supported these theories. Clinical studies of RCR in diabetics have found a trend towards higher complication rate, but similar functional outcomes, when compared to non-diabetics. These trends need to be validated by studies with higher levels of evidence.
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