Assessing the influence of obesity on rotator cuff repair surgical and functional outcomes: a meta-analysis.

BACKGROUND

Obesity is a major global health burden and is linked to numerous comorbidities, including musculoskeletal disorders. Among these, rotator cuff disorders are a leading cause of shoulder pain. Although the impact of obesity on procedures such as hip and knee arthroplasty is well documented, its effect on rotator cuff repair has been less explored. This meta-analysis aimed to evaluate the influence of obesity on surgical and functional outcomes following rotator cuff repair.

METHODS

The review was conducted following the PRISMA guidelines and registered in PROSPERO (CRD42024556254). A comprehensive search of PubMed, Google Scholar, and Web of Science was performed. The outcomes evaluated included functional outcomes such as the American Shoulder and Elbow Surgeons score and range of motion. For surgical outcomes, the variables evaluated included retear, readmission, and reoperation. Statistical analysis was performed via Review Manager (Cochrane Collaboration. Review Manager [RevMan], London, UK. Version 5.4 2020) and Comprehensive Meta-Analysis v3 software.

RESULTS

Twelve studies comprising 79098 patients were included. The obese patients had significantly poorer functional outcomes, with lower Single Assessment Numeric Evaluation and American Shoulder and Elbow Surgeons scores. Obese patients also had statistically significant impairments in the internal rotation function of the shoulder joint. These patients also exhibited a higher risk of readmission and reoperation. No significant differences were found in terms of operative time, postoperative pain, or surgical site infection.

CONCLUSION

Obesity negatively impacts the surgical and functional outcomes of rotator cuff repair, leading to worse functional scores, limited range of motion, and increased risks of readmission and reoperation. These findings underscore the importance of weight management strategies to optimize outcomes for obese patients undergoing rotator cuff repair.