Outcomes of Arthroscopic Rotator Cuff Repair after Bariatric Surgery.

BACKGROUND: Bariatric surgery (BS) is an increasingly utilized intervention for the treatment of obesity. However, BS is also associated with postoperative nutritional deficiencies that may affect healing rates after orthopaedic procedures.

PURPOSE: To compare failure rates and patient-reported outcomes after arthroscopic rotator cuff repair (RCR) between patients with and without a history of BS.

METHODS: Patients in a single institution with a history of BS who underwent arthroscopic RCR for full-thickness supraspinatus tears were identified. These patients were matched in a 1:3 ratio by age, sex, and body mass index to patients without a history of BS who underwent arthroscopic RCR. The minimum follow-up was 24 months. The primary outcome was surgical failure. Secondary outcomes assessed included the numeric rating scale (NRS) score for pain, Single Assessment Numeric Evaluation (SANE) score, American Shoulder and Elbow Surgeons (ASES) Shoulder Score, need for manipulation under anesthesia (MUA) or arthroscopic lysis of adhesions (LOA), infection requiring reoperation, and conversion to reverse total shoulder arthroplasty (rTSA).

RESULTS: A total of 34 arthroscopic patients with a history of BS who underwent RCR were matched to 102 patients without BS. The BS group had significantly higher overall failure rates (20.6% vs 6.9%; P = .044) than patients without BS. The BS group had significantly higher postoperative NRS pain scores (3.9 vs 1.3; P < .001), lower SANE scores (77.7 vs 87.7; P = .041), and lower ASES scores (72.6 vs 90.4; P < .001) at the final follow-up. Rates of revision RCR, reoperation for MUA or LOA, and conversion to rTSA were not statistically significantly different (P > .050 for all). No postoperative infections were reported.

CONCLUSION: A history of BS is associated with increased failure rates, worse postoperative pain, and worse patient-reported outcomes after arthroscopic RCR. Patients with a history of BS and those considering BS before arthroscopic RCR should be counseled regarding a possible risk for inferior outcomes after surgery.

STUDY DESIGN: Cohort study; Level of evidence: 3.