Osteoporosis is a risk factor for complications and reoperations at 1 and 3 years after arthroscopic rotator cuff...

Osteoporosis is associated with compromised bone quality and healing potential. Arthroscopic rotator cuff repair (RCR) restores shoulder function and reduces pain in patients with rotator cuff pathology. The influence of osteoporosis on complications and long-term outcomes following RCR remains underexplored. This study aims to evaluate the relationship between osteoporosis and outcomes after arthroscopic RCR.

The PearlDiver Mariner 170 dataset was retrospectively analyzed. Patients were grouped by whether they had a diagnosis of osteoporosis within the year prior to RCR. The 2 groups were propensity score matched 1:1 on age, gender, and comorbidities. Outcomes were assessed at 1 year and 3 years post-operatively. The outcomes of interest included repeat RCR, Surgical Site Infection, frozen shoulder (FS), proximal humerus fracture, total shoulder arthroplasty (TSA), and lysis of adhesions/manipulation under anesthesia.

After propensity score matching, there were no differences in demographics and comorbidities between groups. At 1 year post-operatively, the osteoporosis group had increased rates of FS (3.7% vs. 3.1%; P = .004), proximal humerus fracture (0.6% vs. 0.4%; P = .002), and TSA (1.2% vs. 0.9%; P = .012). This trend persisted at 3 years post-operatively, with the osteoporosis group continuing to have increased rates of FS (4.8% vs. 4.0%; P < .001), proximal humerus fracture (1.0% vs. 0.7%; P = .001), and TSA (2.2% vs. 1.9%; P = .038).

Patients with osteoporosis are at increased risk of FS, proximal humerus fractures, and TSA at 1 and 3 years after arthroscopic RCR. Overall rates of complication were low and osteoporosis should not be considered a contraindication to arthroscopic RCR.