Effect of Metabolic Syndrome in the incidence of Rotator Cuff Injury and Recovery following Surgical Repair

Author(s): Sugeeth Kandikattu, Manas Aavula, Timothy Pisarski, David Parvizi, Devendra K Agrawal

Rotator cuff injuries are prevalent and have a plethora of risk factors that play a role in both the incidence of injury and recovery from surgical repair. One of the major contributors is metabolic syndrome, which has a variety of different elements that affect the issue under discussion such as hypertension, hyperglycemia, hyperlipidemia, and obesity, which are highly prevalent in patients troubled with this injury. The purpose of this article is to critically review the information from various scientific reports on the underlying cellular and molecular mechanisms of metabolic syndrome increasing the rate of injury and delaying recovery after repair. After critical examination of the findings from many publications in this area, it can be concluded that the factors associated with the metabolic syndrome play a negative role and support the underlying thesis on prolonged recovery with poor outcome following tendon repair in the shoulder. Diabetes Mellitus with elevated insulin levels increases inflammation and cell apoptosis, decreasing healing factors post-surgery. The occurrence of hyperlipidemia and obesity can increase the deposition of xanthomas and the release of adipokines, respectively, which has been proven to delay wound healing as well as increase the risk of reinjury. Studies have also shown that patients with metabolic syndrome who have had a rotator cuff repair tend to have prolonged hospital stays, a higher incidence of reinjury, and increased instances of rehospitalization. The findings together further emphasize the negative effect of metabolic syndrome and how its actions can affect the outcome of the recovery process and lifestyle of a patient post-surgery. These findings further establish the critical consideration of such factors as a cause for incidence, reinjury/rehospitalization, and prolongation of surgical recovery.