Obesity causes poorer clinical results and higher re-tear rates in rotator cuff repair

The purpose of this retrospective study was to report on the functional outcome after both open and arthroscopic rotator cuff (RC) repair in normal weight, pre-obese and obese patients. It was hypothesized that obesity is a negative prognostic factor for clinical outcome and failure for the RC repair. One hundred and forty-six patients who underwent either open or arthroscopic rotator cuff repair between 2006 and 2010 were included in this study. Seventy-five patients (56.7 +/- 10.1 years of age) after open RC repair and 71 patients (59.0 +/- 9.1 years of age) treated arthroscopically were available for evaluation. In both groups a double-row reconstruction was performed. Patients were divided in three groups according to their body-mass index. The mean follow-up was at 43 +/- 16 (minimum 24) months. At follow-up, the clinical outcome was assessed by the DASH and Constant score. An ultrasound of both shoulders was performed in all patients. The mean BMI was 28.3 +/- 5.3 in the arthroscopic group and 27.7 +/- 4.3 in the open group. Overall, in both groups similar clinical results were noted [Constant-Murley score 78.3 +/- 18.2 arthroscopic vs. 77.0 +/- 21.8 for open surgery; DASH 12.7 +/- 18.2 arthroscopic vs. 15.6 +/- 21.6 for open surgery (p = 0.81)]. Both the failure rate and the clinical outcome were significantly worse for obese patients (BMI > 30, p = 0.007). The failure rate was 15.8% for the normal-weight patients, 8.2% in the pre-obese group and in the obese group 28.6%. The RC repair failure occurred in 11 cases in both groups after arthroscopic or open treatment (15.0%). Both the arthroscopic and the open approach showed equivalent clinical results and failure rates. Obesity (BMI > 30) causes less favorable results in the Constant and DASH scores and showed higher re-tear rates.