Prognostic Factors (Higher BMI)
Moderate evidence supports that higher BMI is correlated with higher re-tear rates after rotator cuff repair surgery; however, strong evidence supports that there is no correlation between higher BMI and worse patient-reported outcomes following rotator cuff repair.
Management of Rotator Cuff Injuries
Endorsed by: AANA, ASES, AOSSM, ASSET, APTA

Rationale
One high quality study (Kim 2018) demonstrated that higher BMI was associated with higher re-tear rates after rotator cuff repair.

Four high quality studies demonstrated either no difference in patient reported outcomes for patients with high BMI (Namdari 2010, Potter 2015, Wylie 2018), or improved patient reported outcomes in patients with higher BMI (Chalmers 2018) after rotator cuff repair, in part related to a lower starting ASES scores and pain VAS in patients with higher BMI.

Risks and Harms of Implementing this Recommendation
Patients with higher BMI may be at higher risk for perioperative complications, yet the literature supports that these patients should be treated surgically if indicated, as they can expect improved patient reported outcomes.

Future Research
Patients with higher BMI generally start with lower scores on patient reported outcome measures.  Future research should investigate if this starting point changes with weight loss, and how this affects the improvement in patient reported outcomes after surgery.

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