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The Journal of Bone and Joint Surgery (American) 86:743-747 (2004)
© 2004 The Journal of Bone and Joint Surgery, Inc.

Associations Between Body-Mass Index and Surgery for Rotator Cuff Tendinitis

Aaron M. Wendelboe, MSPH1, Kurt T. Hegmann, MD, MPH2, Lisa H. Gren, MSPH1, Stephen C. Alder, PhD1, George L. White, Jr., PhD, MSPH1 and Joseph L. Lyon, MD, MPH1

1 Public Health Programs, 375 Chipeta Way, Suite A, Salt Lake City, UT 84108
2 391 Chipeta Way, Suite C, Salt Lake City, UT 84108. E-mail address: khegmann{at}dfpm.utah.edu

Investigation performed at the University of Utah, Salt Lake City, Utah

In support of their research or preparation of this manuscript, one or more of the authors received grants or outside funding from the Centers for Disease Control and Prevention/National Institute of Occupational Safety and Health (Training Grant T42/CCT810426-06-1) and the Prostate Lung Colorectal and Ovarian Cancer Screening Trial, University of Utah (contract number N01-CN-25524). None of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: Rotator cuff tendinopathy is a common entity. We hypothesized that obesity, because of biomechanical and systemic risk factors, increases the risks of rotator cuff tendinitis, tears, and related surgical procedures.

Methods: A frequency-matched case-control study was conducted. Three hundred and eleven patients who were fifty-three to seventy-seven years old and who underwent rotator cuff repair, arthroscopy, and/or other repair of the shoulder in a large hospital from 1992 to 2000 were included in the study. These surgical procedures were used as proxies for the risk of rotator cuff tendinitis. These patients were age and frequency-matched to 933 controls, who were randomly drawn from a pool of 10,943 potential controls consisting of Utah state residents who were enrolled in a large cancer-screening trial. Age-adjusted odds ratios were calculated with use of the International Classification of Diseases, Ninth Revision procedural codes and body-mass-index groups. The data were stratified according to gender and age. Multiple linear regression analyses also were performed.

Results: There was an association between increasing body-mass index and shoulder repair surgery. The highest odds ratios for both men (odds ratio = 3.13; 95% confidence interval = 1.29 to 7.61) and women (odds ratio = 3.51; 95% confidence interval = 1.80 to 6.85) were for individuals with a body-mass index of ≥35.0 kg/m2. Tests for trend also were highly significant for both men (p = 0.002) and women (p ≤ 0.001). Multiple linear regression analysis also indicated a significant association between increasing body-mass index and shoulder surgery (beta = 1.57; 95% confidence interval = 0.97 to 2.17; p ≤ 0.001).

Conclusions: There is an association between obesity and shoulder repair surgery in men and women who are fifty-three to seventy-seven years of age. The results of the present study suggest that increasing body-mass index is a risk factor for rotator cuff tendinitis and related conditions.

Clinical Relevance: Individuals who are obese are at increased risk for rotator cuff tendinitis and rotator cuff-related surgery. This apparent risk increases with the degree of obesity.

Level of Evidence: Prognostic study, Level II-1 (retrospective study). See Instructions to Authors for a complete description of levels of evidence.


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