Effects of obesity on function, pain, and complications after rotator cuff repair: An updated systematic review and meta-analysis

This meta-analysis aimed to determine the impact of obesity on function, pain, complication and patient-reported outcome measure following rotator cuff repair. This meta-analysis compares patients with obesity and without obesity undergoing rotator cuff repair surgery in terms of effectiveness, safety, and patient-reported measures. Four major databases were searched. Odds ratios, mean differences, and standard mean differences with 95 % confidence intervals (CIs) were calculated. The meta-analysis was performed using Review Manager version 5.4. Sixteen studies (n = 139,638 patients) were included. At the final follow-up, patients with obesity had significantly higher visual analogue scale (VAS) pain (SMD 0.16, 95 % CI 0.03-0.29). Patients with obesity had lower American Shoulder and Elbow Surgeons Shoulder Score (ASES) scores (MD -4.70, 95 % CI -7.57 to -1.82). No differences were observed in range of motion (ROM). Patients with obesity had a higher overall complication risk (OR 1.64, 95 % CI 1.38-1.95; I2 = 19 %) driven by obesity (OR 1.66, 95 % CI 1.29-2.13) and severely subgroups with obesity (OR 1.84, 95 %CI 1.43-2.37). Patients with obesity had significantly higher risks of thrombosis, myocardial infarction, cardiac arrest and renal complications. They also showed significantly higher reoperation (OR 1.31, 95 % CI 1.21-1.43) and readmission rates (OR 1.37, 95 % CI 1.31-1.44). Obesity is associated with worse pain and function and higher complication rates after rotator cuff repair. These findings have implications for perioperative counseling and management in this population.