The Effect of Vitamin D Deficiency on Post-operative Outcomes Following Rotator Cuff Repair: A Meta-Analysis

Rotator cuff injuries (RCIs) are common and debilitating injuries, particularly among older adults. Surgical repair, such as arthroscopic rotator cuff repair (RCR), is the preferred treatment, with pre-operative risk factors, including vitamin D deficiency, associated with poor outcomes, but the relationship between vitamin D deficiency and outcomes following RCR remains uncertain. The purpose of this meta-analysis was to investigate the relation between pre-operative vitamin D deficiency and post-operative outcomes following RCR. A systematic review and meta-analysis were conducted to explore the association including randomized clinical trials, observational studies, and case-series with more than 10 adult participants (age > 18) evaluating post-operative outcomes in vitamin D-deficient RCR patients. Six studies encompassing 44,546 patients with RCIs were included. Vitamin D deficiency was significantly associated with an increased risk of surgery revision (RR 1.220; 95% CI 1.133, 5.245; p < .001). However, there was no significant correlation between vitamin D deficiency and post-operative pain (p = .064), tear size (p = .480), or functional scores, including ASES (p = .820), Constant score (p = .365), and UCLA score (p = .780). This study revealed that vitamin D deficiency increased the risk of surgery revision to address repair failure following RCR by 22% in vitamin D-deficient patients. No significant associations were found with post-operative pain, which could be related to the limited number of studies. Further studies are still needed to yield more conclusive results.