Abstract
Introduction: Rotator cuff repair is a widely performed orthopedic surgical procedure to ease pain and restore shoulder movement in individuals with tears in the rotator cuff. This meta-analysis examined the relationship between preoperative HbA1c levels and susceptibility to postoperative complications following rotator cuff tear repair surgery. Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines. Relevant studies published until July 2023 were identified across multiple databases. Results: The meta-analysis included 14 articles (3 prospective, 11 retrospective) with 113,286 diabetic and 342,895 non-diabetic patients. Diabetic patients were slightly older on average. There were more males and smokers in the non-diabetic group, while the diabetic group had more hypertensive patients. Diabetic patients had worse outcomes, including higher rates of rotator cuff retears (RR 1.62;95%1.27, 2.06; P<0.001). Non-diabetic patients generally achieved better healing (OR;2.68;95%CI;1.45,4.95;P=0.002), pain, and range of motion improvements. Diabetes did not significantly impact infection risk or hospital utilization. Conclusions: The findings suggest that optimizing glycemic control in diabetic patients may be important for improving outcomes following rotator cuff repair. This opens new avenues for research to understand the mechanisms driving the differences in outcomes between diabetic and non-diabetic patients. Developing strategies to minimize the negative impact of diabetes on rotator cuff injuries and repair procedures could be beneficial.
Published Version
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