Effect of Elevated BMI on Shoulder Stabilization Outcomes and Recurrence Rates

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biostatistics

Background:

• Body mass index (BMI) is a known factor in hip and knee procedures, but its impact on shoulder instability surgery outcomes is less understood.
• This study investigates the relationship between BMI and clinical outcomes, including recurrence rates, following shoulder instability surgery.

Purpose of the Study:

• To analyze the association between body mass index (BMI) and clinical outcomes after shoulder instability surgery.
• To determine if elevated BMI affects recurrence rates in patients undergoing shoulder instability procedures.

Main Methods:

• A retrospective cohort study of 509 patients who underwent shoulder instability surgery between 2009 and 2023.
• Patients were stratified into underweight/normal weight (BMI ≤25 kg/m²), overweight (BMI >25 to ≤30 kg/m²), and obese (BMI >30 kg/m²) groups.
• Clinical outcomes and functional markers were collected and analyzed across BMI cohorts.

Main Results:

• Obese patients exhibited higher depression rates and significantly lower postoperative internal rotation compared to normal weight and overweight patients.
• Despite statistical differences in range of motion, these were not clinically significant.
• The overall instability recurrence rate was 27% for obese patients versus 16% for normal/underweight and 13% for overweight patients (P = .33).

Conclusions:

• Shoulder instability surgery outcomes are not significantly associated with obesity.
• While some range of motion differences exist, they are not clinically significant and may be due to body habitus.
• Shoulder instability surgery is a safe and effective procedure irrespective of a patient's BMI.