Severe Obesity Is Not Associated With Worse Functional Outcomes Following Arthroscopic Rotator Cuff Repair

Purpose: The purpose of this study is to investigate the outcomes of arthroscopic rotator cuff repair in a severely obese population (body mass index [BMI] > 0 kg/m²) compared to a healthy weight population (BMI 18.5-24.9 kg/m²). Methods: This study is a retrospective review of prospectively collected data examining the outcomes of arthroscopic rotator cuff repair in both severely obese patients and healthy weight patients. Primary outcome measures analyzed include the American Shoulder and Elbow Surgeons (ASES) Score, the Single Assessment Numeric Evaluation (SANE), pain Visual Analog Scale (VAS), range of motion, and complications. Results: A total of 89 patients met inclusion/exclusion criteria: 52 healthy weight patients (BMI 18.5-24.9 kg/m²) and 37 severely obese patients (BMI >40 kg/m²). Patient-reported pain and functional outcomes had significantly improved after surgery in both groups with regard to the visual analog score (VAS) scores, Single Assessment Numeric Evaluation (SANE) scores, and American Shoulder and Elbow Surgeons Shoulder (ASES) scores (P < .0001). When directly comparing the outcomes in the healthy weight group to the severely obese group, the latter had significantly inferior outcomes in VAS scores (P = .0048), SANE scores (P = .0118), ASES scores (P = .0031), and postoperative internal rotation (P =.0132). At large, these outcomes did not have clinically significant differences. The severely obese group also had higher total numbers of comorbid conditions and longer operative times (P =.0041). Conclusions: Severely obese patients and their associated comorbid conditions pose unique challenges in rotator cuff tear management, but they still achieve overall excellent outcomes after repair and noninferior clinical differences when compared to healthy weight patients. Level of Evidence: Level III, retrospective comparative study.