Background: In a previous study, we found that medical comorbidities
have a negative effect on preoperative pain, function, and general health
status in patients with a chronic rotator cuff tear. In this study, we
evaluated the relationship between medical comorbidities and the postoperative
outcome of rotator cuff repair.
Methods: One hundred and twenty-five patients were evaluated on the
basis of a history (including medical comorbidities) and use of outcome tools
preoperatively and at one year after rotator cuff repair. Outcome was
evaluated with the Disabilities of the Arm, Shoulder and Hand (DASH)
Questionnaire, the Simple Shoulder Test (SST), visual analog scales (pain,
function, and quality of life), and the Short Form-36 (SF-36).
Results: The mean number of medical comorbidities was 1.91 (range,
zero to six). At one year after rotator cuff repair, there were no significant
correlations between comorbidities and pain, shoulder function, or quality of
life as determined with the SST, DASH, and visual analog scales (p > 0.05).
A greater number of comorbidities was associated with a worse postoperative
general health status (SF-36 role emotional [p = 0.045], SF-36 bodily pain [p
= 0.032], SF-36 general health [p = 0.001], and SF-36 vitality [p = 0.033]).
Nevertheless, a greater number of comorbidities was associated with greater
improvement, compared with the preoperative status, in the pain score on the
visual analog scale (p = 0.009), function as assessed with the visual analog
scale (p = 0.022) and the DASH (p = 0.044), and quality of life as assessed
with the visual analog scale (p = 0.041).
Conclusions: Patients with more medical comorbidities have a worse
general health status after rotator cuff repair. Interestingly, it also
appears that these patients have greater improvement in overall shoulder pain,
function, and quality-of-life scores compared with preoperative scores.
Therefore, despite a negative effect of comorbidities on outcomes, patients
with more comorbidities have greater improvement after the repair, to the
point where postoperative shoulder function and pain are not significantly
influenced by medical comorbidities. Consequently, a higher number of medical
comorbidities should not be considered a negative factor in determining
whether a patient should undergo rotator cuff repair.
Level of Evidence: Therapeutic Level III. See
Instructions to Authors for a complete description of levels of evidence.