Journal article
Obesity and sex influence fatty infiltration of the rotator cuff: the Rotator Cuff Outcomes Workgroup (ROW) and Multicenter Orthopaedic Outcomes Network (MOON) cohorts
Journal of shoulder and elbow surgery, Vol.31(4), pp.726-735
04/2022
DOI: 10.1016/j.jse.2021.12.011
PMCID: PMC8940702
PMID: 35032677
Abstract
Fatty infiltration (FI) is one of the most important prognostic factors for outcomes after rotator cuff surgery. Established risk factors include advancing age, larger tear size, and increased tear chronicity. A growing body of evidence suggests that sex and obesity are associated with FI; however, data are limited.
We recruited 2 well-characterized multicenter cohorts of patients with rotator cuff tears (Multicenter Orthopaedic Outcomes Network [MOON] cohort [n = 80] and Rotator Cuff Outcomes Workgroup [ROW] cohort [n = 158]). We used multivariable logistic regression to evaluate the relationship between body mass index (BMI) and the presence of FI while adjusting for the participant’s age at magnetic resonance imaging, sex, and duration of shoulder symptoms, as well as the cross-sectional area of the tear. We analyzed the 2 cohorts separately and performed a meta-analysis to combine estimates.
A total of 27 patients (33.8%) in the Multicenter Orthopaedic Outcomes Network (MOON) cohort and 57 patients (36.1%) in the Rotator Cuff Outcomes Workgroup (ROW) cohort had FI. When BMI < 25 kg/m2 was used as the reference category, being overweight was associated with a 2.37-fold (95% confidence interval [CI], 0.77-7.29) increased odds of FI and being obese was associated with a 3.28-fold (95% CI, 1.16-9.25) increased odds of FI. Women were 4.9 times (95% CI, 2.06-11.69) as likely to have FI as men.
Among patients with rotator cuff tears, obese patients had a substantially higher likelihood of FI. Further research is needed to assess whether modifying BMI can alter FI in patients with rotator cuff tears. This may have significant clinical implications for presurgical surgical management of rotator cuff tears. Sex was also significantly associated with FI, with women having higher odds of FI than men. Higher odds of FI in female patients may also explain previously reported early suboptimal outcomes of rotator cuff surgery and higher pain levels in female patients as compared with male patients.
Details
- Title: Subtitle
- Obesity and sex influence fatty infiltration of the rotator cuff: the Rotator Cuff Outcomes Workgroup (ROW) and Multicenter Orthopaedic Outcomes Network (MOON) cohorts
- Creators
- Ayush Giri - Vanderbilt University Medical CenterThomas H. Freeman - Vanderbilt University Medical CenterPeter Kim - Vanderbilt University Medical CenterJohn E. Kuhn - Vanderbilt University Medical CenterGustavo A. Garriga - Vanderbilt University Medical CenterMichael Khazzam - The University of Texas Southwestern Medical CenterLaurence D. Higgins - King Edward Memorial HospitalElizabeth Matzkin - Brigham and Women's HospitalKeith M. Baumgarten - University of Sioux FallsJulie Y. Bishop - The Ohio State UniversityRobert H. Brophy - Washington University in St. LouisJames L. Carey - University of PennsylvaniaWarren R. Dunn - Texas Orthopedic HospitalGrant L. Jones - The Ohio State UniversityC. Benjamin Ma - University of California, San FranciscoRobert G. Marx - Cornell UniversityEric C. McCarty - University of Colorado DenverSourav K. Poddar - University of Colorado DenverMatthew V. Smith - Washington University in St. LouisEdwin E. Spencer - Tennessee Orthopaedic ClinicsArmando F. Vidal - Steadman Philippon Research InstituteBrian R. Wolf - University of IowaRick W. Wright - Vanderbilt University Medical CenterNitin B. Jain - Vanderbilt University Medical Center
- Resource Type
- Journal article
- Publication Details
- Journal of shoulder and elbow surgery, Vol.31(4), pp.726-735
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.jse.2021.12.011
- PMID
- 35032677
- PMCID
- PMC8940702
- ISSN
- 1058-2746
- eISSN
- 1532-6500
- Grant note
- DOI: 10.13039/100000002, name: NIH
- Language
- English
- Date published
- 04/2022
- Academic Unit
- Orthopedics and Rehabilitation; Physical Therapy and Rehabilitation Science
- Record Identifier
- 9984295055402771
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