Study finds decreased benefit from shoulder arthroplasty in patients with obesity
SAN DIEGO — Compared with patients without obesity, patients with obesity who undergo anatomic or reverse total shoulder arthroplasty generally experience more pain, worse outcomes and less range of motion, according to a presenter.
“The purpose of this study is to determine the effects of obesity on clinical and functional outcomes scores following primary anatomic and reverse total shoulder arthroplasty in a large patient population with midterm follow-up,” Richard J. Friedman, MD, FAAOS, said in his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.
Friedman and colleagues from the Medical University of South Carolina performed a prospective cohort study on 1,520 patients undergoing primary anatomic total shoulder arthroplasty (aTSA) and 2,054 patients undergoing reverse total shoulder arthroplasty (rTSA) from 2005 to 2016. Patients had a minimum follow-up of 2 years. According to the abstract, obese patients were defined as those with a BMI greater than or equal to 30 kg/m2. Overall, 630 patients in the aTSA cohort (41%) were classified as obese and 714 patients in the rTSA cohort (35%) were classified as obese.
Despite statistically significant postoperative improvements in both obese and non-obese patients, Friedman and colleagues found obese patients had increased intraoperative blood loss, worse pain and clinical outcome scores, and decreased preoperative and postoperative range of motion compared with non-obese patients.
“With this information in mind, surgeons and patients can make more informed decisions regarding the indications, contraindications and expected outcomes for both anatomic and reverse shoulder arthroplasty in the obese population,” Friedman concluded.