Does obesity affect early outcome of rotator cuff repair? Surena Namdari, MD, MSc a , Keith Baldwin, MD, MPH, MSPT a , David Glaser, MD a , Andrew Green, MD b, * a Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA b Department of Orthopaedic Surgery, Warren Alpert Medical School Brown University/Rhode Island Hospital, Providence, RI, USA Background: Obesity is linked to major health conditions and poor surgical outcomes. The impact of obesity on self-perceived outcome after rotator cuff repair (RCR) is unclear. Materials and methods: We studied 154 patients who underwent RCR. Obesity was considered a body mass index (BMI) greater than 30. Preoperative and postoperative evaluations included the Disabilities of the Arm, Shoulder and Hand (DASH), Simple Shoulder Test, and visual analog scales for pain, function, and quality of life. Obese and control patients were compared for baseline demographics, surgical findings, and postoperative outcomes. Results: Our overall population had a mean BMI of 28.4 (95% confidence interval, 27.7-29.1). There were 57 obese patients (BMI >30) and 97 nonobese patients with 1- or 2-tendon rotator cuff tears. Mean follow- up was 54.8 weeks (range, 52.0-88.7 weeks). Preoperative DASH score was 45.2 for obese patients and 43.4 for control patients (P ¼ .524). The mean improvement in DASH score was 30.7 for obese patients and 26.1 for nonobese patients (P ¼ .152). There were no significant differences in the Simple Shoulder Test and visual analog scale scores. Worse follow-up DASH scores in both groups were associated with worker’s compensation status (P ¼ .003) and total comorbidities (P < .001). Multiple linear regression analysis showed that BMI (continuous) and obesity (dichotomous) were not significantly related to outcome after we controlled for confounding variables. Conclusions: Although obesity is considered a risk factor for poor postoperative outcomes after some surgical procedures, in our experience, obesity does not have an independent, significant effect on self- reported early outcomes after RCR. Level of evidence: Level III, Retrospective Case Control, Treatment Study. Ó 2010 Journal of Shoulder and Elbow Surgery Board of Trustees. Keywords: Rotator cuff tear; rotator cuff repair; obesity; outcomes; comorbidity; body mass index The World Health Organization defines obesity as a body mass index (BMI) greater than 30 and morbid obesity as a BMI greater than 40. 27 Unfortunately, the prevalence of obesity is increasing in the developed world. It is estimated that 32% of non-institutionalized adults in the United States are obese. 18 Although obesity has been linked to a number of major health conditions including ischemic heart disease, 28 diabetes mellitus, 8 stroke, 8 oste- oarthritis, 8 and chronic renal failure, 6 among others, it is also associated with surgical complications including thromboembolic disease 5 and difficulty with general anesthesia. 1,8 Despite this, obesity as a risk factor for orthopaedic surgery is less commonly evaluated, and the findings have *Reprint requests: Andrew Green, MD, University Orthopedics, 2 Dudley St, Ste 200, Providence, RI 02905. E-mail address: agshoulder@aol.com (A. Green). J Shoulder Elbow Surg (2010) 19, 1250-1255 www.elsevier.com/locate/ymse 1058-2746/$ - see front matter Ó 2010 Journal of Shoulder and Elbow Surgery Board of Trustees. doi:10.1016/j.jse.2010.03.003