Introduction: The obesity epidemic is especially common among the elderly population. As the majority of patients with proximal humeral fractures undergoing a reverse shoulder arthroplasty (RSA) are elderly, it is essential to understand how obesity can impact the outcomes of shoulder arthroplasty in this patient group. However, there is limited consensus on the functional outcome measures and range of motion in obese patients undergoing RSA for fractures compared to non-obese patients.
Materials And Methods: A retrospective study was conducted, including all patients who underwent RSA surgery for proximal humeral fractures from 2010 to 2022. The patients were divided into two groups based on their body mass index (BMI) at the time of surgery: the obese group (BMI ≥ 30 kg/m) and the control group (BMI < 30 kg/m). The primary outcome variable was the Constant-Murley (CM) score. The adjusted CM, quickDASH and UCLA functional scales were used as secondary outcome measures. Complications were also documented, and implant survival was assessed in both groups.
Results: One hundred thirty one patients comprise the final sample of the study, with 65 in the obesity group and 66 in the control group. There were no significant differences in mean scores on the CM (p = 0.068), UCLA (p = 0.169), and QuickDASH scales (p = 0.064). However, differences were found in adjusted CM (p = 0.046), forward flexion (p = 0.013), abduction (p = 0.011), external rotation (p = 0.047), and internal rotation (p = 0.039). The estimated 14-year survival in the obesity group was 92.2% (95% CI 80.0-100), while in the control group, it was 95.0% (95% CI 90.0-100) (p = 0.680).
Conclusions: The obese patient who underwent treatment with RSA for a proximal humeral fracture has functional outcomes and an estimated 14-year survival comparable to those of non-obese patients. However, postoperative shoulder mobility is significantly worse in obese patients at the 2-year postoperative follow-up.
Level Of Evidence: III.
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