Moderate evidence supports the association of poorer patient reported outcomes in patient with more comorbidities

Management of Rotator Cuff Injuries
Endorsed by: AANA, ASES, AOSSM, ASSET, APTA
Moderate Evidence MODERATE EVIDENCE
Rationale
Two high quality studies (Namdari 2010, Tashjian 2006) correlated the number of comorbidities to worse patient reported outcomes in patients who underwent rotator cuff repair surgery.

Risks and Harms of Implementing this Recommendation
While perioperative complications could be increased when performing rotator cuff repair surgery on patients with multiple comorbidities, this should not be used as a contraindication for surgery.  Patients should be counseled that they may be at increased risk for poorer outcomes compared to patients who are healthier.

Future Research
While the number of comorbidities does influence patient reported outcomes after rotator cuff repair surgery, it would be important to understand the risk stratification of specific comorbidities to accurately make recommendations about the expected outcomes.
  1. Namdari, S., Baldwin, K., Glaser, D., Green, A. Does obesity affect early outcome of rotator cuff repair?. Journal of Shoulder & Elbow Surgery 2010; 8: 1250-5
  2. Tashjian, R. Z., Henn, R. F., Kang, L., Green, A. Effect of medical comorbidity on self-assessed pain, function, and general health status after rotator cuff repair. Journal of Bone & Joint Surgery - American Volume 2006; 3: 536-