Functional Outcomes After Total Shoulder Arthroplasty in Obese Patients

Background: Obesity is increasingly prevalent in the United States. There are several reports of outcomes in obese patients after total knee or hip replacement. The purpose of this study was to compare the functional outcomes and complications of obese patients undergoing shoulder arthroplasty with those of overweight or normal-weight patients. Methods: Seventy-six patients who underwent primary total shoulder arthroplasty were grouped according to body mass index. The groups were classified as: normal, which was denoted by a bodymass index of <25 kg/m2 (twenty-six patients); overweight, which was denoted by a body mass index of 25 to 29.9 kg/m2 (twenty-five patients); and obese, which was denoted by a body mass index of ‡30 kg/m2 (twenty-five patients). Preoperative demographics and perioperative and postoperative complications were recorded. The American Shoulder and Elbow Surgeons score, Short Form-36, and visual analog scale pain and fatigue scores were evaluated at baseline and at the two-year follow-up visit. Results: In the normal group, the mean scores (and standard deviation) improved for the American Shoulder and Elbow Surgeons score from 38.4 ± 15.5 points preoperatively to 80.2 ± 19.4 points at two years postoperatively (p < 0.001) and for the Short Form-36 Physical Component Summary score from 38.3 ± 6.5 points preoperatively to 53.7 ± 11.3 points at two years postoperatively (p < 0.001); the visual analog scale pain scores decreased from a mean score of 62 points preoper-atively to 12 points at two years postoperatively (p < 0.001). In the overweight group, the mean scores (and standard deviation) improved for the American Shoulder and Elbow Surgeons score from 37.4 ± 18.1 points preoperatively to 75.2