Rotator Cuff Repair

Rotator-cuff-repair (RCR) surgery is a common orthopedic procedure performed in the outpatient setting with an estimated 300,000 procedures performed per year in the United States[2].

Nutritional status is a key determinant of post-op clinical outcomes.

The rate of RCR is highest in individuals 45–74 years old, in which higher rates of poor nutritional status are observed.

Malnutrition has been shown to be an important risk factor for infections, poor patient outcomes and increased morbidity and mortality. This has been identified in the orthopedic trauma, total joint arthroplasty, and spine as well as rotator cuff repair literature [9,10,12,15–19]

Albumin is a common biomarker used to assess malnutrition, offering a quick and reliable method to screen and diagnose poor nutritional status. 

Preoperative Nutrition Impacts Retear Rate After Arthroscopic Rotator Cuff Repair

  • rotator cuff repair

    Poor nutritional status increases:

    *Hospital Readmission (OR 4.16;p = 0.002)

    *Extended Length of Stay (LOS) (OR 7.47; p < 0.001)

    (CLICK HERE TO READ STUDY)

    P. J. McGlone (2020)

  • arthroscopic rotator cuff repair

    Poor nutritional status increases:

    Preoperative hypoalbuminemia significantly increased adjusted odds ratio of: 

    *Postoperative admission ; 1.7X

    *Extended length of stay; 2.0X

    (CLICK HERE TO READ STUDY)

    T. Quan Journal of Orthopedics (2022)

Poor nutritional status has been linked to higher post-op complication in both arthroscopic and open rotator cuff repair.

Targeted Nutritional Supplementation (TNS) has been successfully used in multiple clinical settings. Enhanced outcomes have been seen for many years in burn, plastic, ulcer, and reconstructive surgery of head & neck cancer. The rationale for supplementing is based primarily on studies that show an increase in wound breaking strength and collagen formation in these challenging patient populations. 

Rotator cuff healing similarly requires robust collagen synthesis to allow for tendon incorporation.  Rotator cuff repairs augmented with TNS may similarly demonstrate improved healing rates. 

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References