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Updated: Jan 11, 2026
Arthroscopic Management of Massive Irreparable Rotator Cuff Tears: Whole Rotator Cable Reconstruction Using Proximal Biceps Tendon Autograft
Published on: June 6, 2025
The Association Between HbA1c Level and the Outcomes of Rotator Cuff Repair Surgery in Patients Managed at a Tertiary
Ahmed AlHussain1, Abdullah M Alghamdi2, Talal H BinMushayt2
1Orthopaedic Surgery, King Abdulaziz Medical City, Riyadh, SAU.
Insights
Glycated hemoglobin (HbA1c) levels did not impact rotator cuff surgery outcomes or complications. However, comorbidities like hypertension and liver disease were linked to higher postoperative HbA1c, suggesting overall health influences recovery.
Area of Science:
- Orthopedic Surgery
- Endocrinology
- Diabetology
Background:
- Rotator cuff tears are a common cause of shoulder dysfunction requiring surgical intervention.
- Diabetes mellitus may impede tendon healing due to chronic inflammation and poor glycemic control, indicated by elevated glycated hemoglobin (HbA1c).
Purpose of the Study:
- To investigate the association between glycated hemoglobin (HbA1c) levels and outcomes following rotator cuff repair surgery.
- To identify factors influencing postoperative HbA1c in patients undergoing rotator cuff repair.
Main Methods:
- A retrospective cohort study involving 41 patients who underwent rotator cuff repair at a tertiary center.
- Analysis included demographics, pre- and postoperative data, functional outcomes, and comorbidities.
- Statistical methods included Fisher's exact test, Spearman's correlation, and independent-sample t-tests.
Main Results:
- Preoperative HbA1c showed no significant correlation with functional improvements in abduction, forward flexion, external rotation, or return to work.
- Complication rates were similar between controlled and uncontrolled HbA1c groups.
- Hypertension and liver disease predicted higher postoperative HbA1c levels.
Conclusions:
- Preoperative HbA1c levels are not associated with functional outcomes or complication rates after rotator cuff repair.
- Comorbidities, rather than glycemic control alone, may significantly influence postoperative HbA1c.
- Comprehensive perioperative assessment and tailored management are crucial for optimizing patient recovery.
Abstract:
Background Rotator cuff tears are a leading cause of shoulder dysfunction and often require surgical repair. Diabetes mellitus can impair tendon healing through chronic inflammation and poor glycemic control, reflected by elevated glycated hemoglobin (HbA1c) levels. This study aimed to explore the association between HbA1c levels and the outcomes of rotator cuff repair surgery in patients managed at a tertiary center. Methodology This retrospective cohort study was conducted at King Abdulaziz Medical City, Riyadh, Saudi Arabia, from February 2020 to February 2025. Data were collected on demographics, pre- and postoperative details, outcomes, and comorbidities. Data were analyzed using Fisher's exact test, Spearman's correlation, independent-sample t-tests, and descriptive statistics, conducted using SPSS version 29.0.0 (IBM Corp., Armonk, NY, USA). Results Of the 79 eligible patients, 38 were excluded due to incomplete HbA1c data, and 41 were analyzed. Most patients were female (28; 68.3%) with a mean age of 57.1 ± 7.6 years (range = 39-69 years). The average body mass index was 30.2 ± 4.3 kg/m², with 18 (43.9%) patients classed as overweight and 19 (46.3%) obese. Common comorbidities included dyslipidemia (32; 78.0%), hypertension (23; 56.1%), and diabetes (21; 51.2%). Preoperative HbA1c showed no correlation with functional improvements in abduction (r = 0.132, p = 0.455), forward flexion (r = -0.082, p = 0.646), external rotation (r = 0.292, p = 0.187), or return to work (r = 0.008, p = 0.961). Complication rates were similar between controlled (6; 66.7%) and uncontrolled (3; 33.3%) HbA1c groups (p = 0.707). Hypertension (B = 1.327, p = 0.032) and liver disease (B = 3.913, p = 0.009) predicted higher postoperative HbA1c, while other comorbidities showed no significant associations. Conclusions Preoperative HbA1c was not associated with postoperative functional outcomes or complications. However, certain comorbidities were linked to higher postoperative HbA1c, suggesting that overall health conditions may influence recovery more than glycemic control alone. These findings highlight the importance of comprehensive perioperative assessment and tailored management strategies to optimize outcomes in rotator cuff repair patients.
