Work

Obesity has no significant association with revision rate and functional outcomes following total shoulder arthroplasty—results from the New Zealand National Joint Registry

Year: 2025

Type: article

Abstract: Background: Globally, the prevalence of both anatomic (aTSA) and reverse (rTSA) total shoulder arthroplasty has markedly increased. This growth coincides with significant growth in the rate of obesity. Despite evidence correlating obesity with inferior outcomes in patients receiving lower-limb arthroplasty, the effect of obesity on shoulder arthroplasty remains unclear. The objective of this study was to evaluate the correlation of obesity with total shoulder arthroplasty outcomes using data from the New Zealand Joint Registry (NZJR). Methods: This study used data collected from the NZJR for patients undergoing primary aTSA and rTSA between January 1, 2011, and December 31, 2022, who had body mass index (BMI) data recorded. In the study, 5628 shoulders were included, including 1696 aTSAs and 3932 rTSAs. The primary outcome measure was all-cause revision rate (rate/100 component years) stratified by BMI class. Secondary outcome measures included the Oxford Shoulder Score. Results: The overall risk of revision for all shoulders was 1.01 for aTSA (95% confidence interval [CI] 0.79-1.26) and 0.70 for rTSA (95% CI 0.57-0.86). The risk of all-cause revision did not increase with increasing BMI class in either the aTSA or rTSA group. Among those who had aTSA, those with class II/III obesity had the lowest revision rate of 0.77 (95% CI 0.39-1.28). Among those who had rTSA, risk of revision remained low among all BMI groups with class II/III obese patients showing a nonsignificant trend toward higher risk of revision (adjusted hazard ratio 1.61 [95% CI 0.81-3.23]). There was no association between elevated BMI and risk for deep infection. There was no association between Oxford Shoulder Score and BMI. Conclusion: The results from the NZJR support the continued use of aTSA and reverse shoulder arthroplasty in the obese population. Obesity was not found to be an independent risk factor for adverse outcomes in shoulder arthroplasty in our study.

Source: JSES International

DOI: 10.1016/j.jseint.2025.01.018

Authors: Dean Ramage, Marc Hirner, Chris Frampton, Ryan Gao

Institutions: Northland District Health Board, University of Otago, North Shore Hospital

Language: English

Topic: Shoulder Injury and Treatment

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,250