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Tytuł:
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Obesity and sex influence fatty infiltration of the rotator cuff: the Rotator Cuff Outcomes Workgroup (ROW) and Multicenter Orthopaedic Outcomes Network (MOON) cohorts.
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Autorzy:
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Giri A; Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Division of Quantitative Sciences, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN, USA.
Freeman TH; Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Kim P; Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, USA.
Kuhn JE; Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Garriga GA; Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Division of Quantitative Sciences, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN, USA.
Khazzam M; Department of Orthopaedics, University of Texas Southwestern, Dallas, TX, USA.
Higgins LD; King Edward Memorial Hospital, Hamilton, Bermuda.
Matzkin E; Department of Orthopaedic Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Baumgarten KM; Orthopedic Institute of Sioux Falls, Sioux Falls, SD, USA.
Bishop JY; Departments of Orthopaedic Surgery and Sports Medicine, Ohio State University, Columbus, OH, USA.
Brophy RH; Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO, USA.
Carey JL; Department of Orthopaedic Surgery, University of Pennsylvania and Perelman School of Medicine, Philadelphia, PA, USA.
Dunn WR; Department of Clinical Research, Fondren Orthopedic Group, Houston, TX, USA.
Jones GL; Departments of Orthopaedic Surgery and Sports Medicine, Ohio State University, Columbus, OH, USA.
Ma CB; Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, USA.
Marx RG; Department of Orthopedic Surgery, Weill Medical College of Cornell University, New York, NY, USA.
McCarty EC; Department of Orthopedic Sports Medicine, University of Colorado, Denver, CO, USA.
Poddar SK; Department of Orthopedic Sports Medicine, University of Colorado, Denver, CO, USA.
Smith MV; Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO, USA.
Spencer EE; Shoulder & Elbow Division, Knoxville Orthopaedic Clinic, Knoxville, TN, USA.
Vidal AF; The Steadman Clinic and Steadman Philippon Research Institute, Vial, CO, USA.
Wolf BR; Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, USA.
Wright RW; Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Jain NB; Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, USA; Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Population & Data Sciences, University of Texas Southwestern, Dallas, TX, USA. Electronic address: .
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Źródło:
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Journal of shoulder and elbow surgery [J Shoulder Elbow Surg] 2022 Apr; Vol. 31 (4), pp. 726-735. Date of Electronic Publication: 2022 Jan 13.
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Typ publikacji:
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Journal Article; Meta-Analysis
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Język:
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English
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Imprint Name(s):
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Publication: St. Louis, MO : Mosby
Original Publication: St. Louis, MO : Mosby Yearbook, Inc., c1992-
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MeSH Terms:
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Obesity*/complications
Rotator Cuff*/pathology
Rotator Cuff*/surgery
Rotator Cuff Injuries*/complications
Rotator Cuff Injuries*/diagnostic imaging
Rotator Cuff Injuries*/surgery
Sex Factors*
Adipose Tissue ; Female ; Humans ; Male ; Multicenter Studies as Topic ; Orthopedics ; Risk Factors
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Grant Information:
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R01 AR074989 United States AR NIAMS NIH HHS; UL1 TR000445 United States TR NCATS NIH HHS
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Contributed Indexing:
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Keywords: Rotator cuff; body mass index; cross-sectional study; fatty infiltration; obesity; sex
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Entry Date(s):
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Date Created: 20220115 Date Completed: 20220322 Latest Revision: 20240214
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Update Code:
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20240214
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PubMed Central ID:
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PMC8940702
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DOI:
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10.1016/j.jse.2021.12.011
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PMID:
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35032677
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Background: 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.
Methods: 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.
Results: 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/m 2 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.
Conclusions: 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.
(Copyright © 2022 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.)
