Patients with diabetes mellitus experience poorer outcomes after arthroscopic rotator cuff repair

Abstract

Hypothesis The purpose of this study was to identify potential differences using validated clinical outcome instruments between patients with and without diabetes mellitus (DM) after arthroscopic rotator cuff repair (RCR). Methods Six-hundred eighty-four patients (32 with and 652 without DM) who underwent arthroscopic RCR were prospectively followed using the visual analog pain scale, Simple Shoulder Test, Single Assessment Numeric Evaluation, American Shoulder and Elbow Surgeons score, and Veterans RAND 12-item Health Survey (mental and physical component scores) preoperatively and at 3, 6, 12, and 24 months postoperatively. Results Patients with DM experienced significantly more pain ( P = .0172) and had lower Simple Shoulder Test ( P = .0458) and American Shoulder and Elbow Surgeons ( P = .0200) scores than patients without DM 6 months after surgery. Although differences between groups are seen at other postoperative time points, none are statistically significant. They also exhibited lower self-rated mental health status at 12 months ( P = .0034) and 24 months ( P = .0077), as well as lower self-rated physical health status at 12 months ( P = .0223) and 24 months ( P = .0077). Changes in scores from preoperatively to postoperatively were not different for patients with DM vs. without DM. Conclusion Patients with DM experience significantly more pain, exhibit significantly poorer shoulder function, and report persistently diminished mental and physical health status compared with their counterparts without DM after undergoing arthroscopic RCR. Although these differences did not reach the minimal clinically important difference, orthopedic surgeons should be cognizant of DM as an outcome-modifying variable when selecting, counseling, and treating patients with rotator cuff tears. Glycemic control should be scrutinized and optimized during the perioperative medical evaluation and ultimately factored into the surgical risk profile and prognosis.

Arthritis Severity and Medical Comorbidities Are Prognostic of Worse Outcomes Following Arthroscopic Rotator Cuff Repair in Patients With Concomitant Glenohumeral Osteoarthritis

“…This is consistent with the literature in the general population, as Sayegh et al. 41 and Berglund et al. 42 both demonstrated that patients with diabetes mellitus undergoing arthroscopic RCR experienced more pain and had poorer ASES scores at 6 and 12 months.…”

Cardiovascular Disease Risk Factors Predict the Development and Numbers of Common Musculoskeletal Disorders in a Prospective Cohort

“…Having greater numbers of cardiovascular disease (CVD) risk factors has been associated with both increased risk of, and severity of, rotator cuff tears 84 . Cardiovascular risk factors have also been shown to result in worse function and poorer healing of surgically repaired rotator cuff tendons 85–88 …”

“…84 Cardiovascular risk factors have also been shown to result in worse function and poorer healing of surgically repaired rotator cuff tendons. [85][86][87][88]…”