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Obesity Has Minimal Impact on Short-Term Functional Scores After Reverse Shoulder Arthroplasty for Rotator Cuff Tear Arthropathy

The American Journal of Orthopedics. 2016 May;45(4):E180-E186
May 9, 2016 | The American Journal of Orthopedics
Morris BJ ; Haigler RE ; Cochran JM
Author and Disclosure Information

Brent J. Morris, MD, Richard E. Haigler, MD, John M. Cochran, BS, Mitzi S. Laughlin, PhD, Hussein A. Elkousy, MD, Gary M. Gartsman, MD, and T. Bradley Edwards, MD

Authors’ Disclosure Statement: Dr. Morris reports that he is a paid consultant to Tornier, Inc. (now Wright Medical Group, Inc.). Dr. Edwards reports that he received financial support from Tornier, Inc. for the database used to collect data for this study and that he receives royalties from and is a consultant to Tornier, Inc. (now Wright Medical Group, Inc.). The other authors report no actual or potential conflict of interest in relation to this article.

The potential adverse effect of body mass index (BMI) on shoulder function scores after reverse shoulder arthroplasty (RSA) has not been investigated.

We conducted a study to examine outcomes of RSA performed for rotator cuff tear arthropathy (RCTA) across BMI categories (normal weight, overweight, obese). We hypothesized that, compared with normal-weight patients, obese patients would have worse shoulder function scores, worse mobility, and more complications.

Using a prospective shoulder arthroplasty registry, we identified 77 primary RSAs performed for RCTA with minimum 2-year follow-up. Thirty-four patients had normal weight (BMI <25 kg/m2), 21 were overweight (BMI 25-30 kg/m2), and 22 were obese (BMI >30 kg/m2). Shoulder function scores, mobility, and satisfaction were evaluated before surgery and at final follow-up.

The 3 BMI groups were not significantly different on demographic factors, preoperative shoulder function scores, or preoperative mobility (P > .05). For each group, shoulder function scores and mobility significantly improved between the preoperative and final follow-up assessments (P < .001). Patient satisfaction was similar between groups (P  = .967).

Improved shoulder function scores, mobility, and patient satisfaction can be expected after RSA for RCTA in patients regardless of BMI.

The primary limitation of this study was its retrospective design. Strengths of the study included its having a single surgeon and a single diagnosis: RCTA. In addition, each group was robust in size, a standard operative/postoperative protocol was used, and clinical results were measured with multiple validated shoulder function scores.

Conclusion

Improved shoulder function scores, mobility, and patient satisfaction can be expected after RSA for RCTA in patients with BMI higher than 30 kg/m2. These patients did not exhibit an increase in complications at short-term follow-up.

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