METHODS: We searched PubMed, EMBASE, and Scopus databases for relevant observational studies (cohort and case-control) and randomized controlled trials (RCTs). The target population in the included studies comprised adults who had undergone rotator cuff repair procedures. The outcomes of interest were functional outcomes (such as range of motion), pain scores, patient-reported outcome measures, and complication rates (such as re-repair and readmission rates). We applied random-effects models and calculated pooled effect sizes reported as standardized mean differences (SMDs) or relative risks (RRs) with 95% confidence intervals.
RESULTS: We analysed data from 11 studies. In most, the follow-up periods ranged from 12 to 60 months. Obese individuals experienced greater pain (SMD 0.30; 95% CI, 0.10, 0.50) and lower shoulder function (SMD -0.33; 95% CI, -0.54, -0.12) than other individuals in the long-term post-operative follow-up. Obese individuals also had higher risks of complications (RR 1.48; 95% CI, 1.11, 1.98) and readmission (RR 1.35; 95% CI, 1.27, 1.43), but a similar likelihood of re-repair (RR, 1.27; 95% CI, 0.82, 1.95) than non-obese/normal BMI individuals. While the forward flexion and external rotation functions were comparable, obese individuals displayed less internal rotation function than other individuals (SMD -0.59; 95% CI, -0.87, -0.30).
CONCLUSIONS: Obesity was associated with unfavourable outcomes after rotator cuff surgery, including increased pain, reduced shoulder function, high risks of complications, and readmission. These findings emphasize the importance of addressing obesity-related factors to improve post-operative outcomes.
方法:我们搜索了PubMed,EMBASE,和Scopus数据库用于相关观察性研究(队列和病例对照)和随机对照试验(RCTs)。纳入研究的目标人群包括接受肩袖修复手术的成年人。感兴趣的结果是功能结果(如运动范围),疼痛评分,患者报告的结果指标,和并发症发生率(如再修复和再入院率)。我们应用了随机效应模型,并计算了以标准化平均差(SMD)或相对风险(RR)报告的合并效应大小,置信区间为95%。
结果:我们分析了11项研究的数据。在大多数情况下,随访期为12~60个月.在长期术后随访中,肥胖个体比其他个体疼痛更大(SMD0.30;95%CI,0.10,0.50)和肩关节功能更低(SMD-0.33;95%CI,-0.54,-0.12)。肥胖个体也有更高的并发症风险(RR1.48;95%CI,1.11,1.98)和再入院风险(RR1.35;95%CI,1.27,1.43),但类似的重新修复可能性(RR,1.27;95%CI,0.82,1.95)比非肥胖/正常BMI个体。虽然前屈和外旋功能相当,肥胖个体的内旋功能低于其他个体(SMD-0.59;95%CI,-0.87,-0.30).
结论:肥胖与肩袖手术后的不良结局相关,包括疼痛加剧,肩部功能降低,并发症的高风险,和重新接纳。这些发现强调了解决肥胖相关因素对改善术后结局的重要性。