{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T22:37:37Z","timestamp":1780612657925,"version":"3.54.1"},"reference-count":38,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T00:00:00Z","timestamp":1710288000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ningxia Hui Autonomous Region key research and development plan project","award":["2021BEG03050"],"award-info":[{"award-number":["2021BEG03050"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>To synthesize the existing evidence on the association between obesity and rotator cuff repair outcomes such as pain, shoulder function, range of motion, and complications.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We searched PubMed, EMBASE, and Scopus databases for relevant observational studies (cohort and case-control) and randomized controlled trials (RCTs). The target population in the included studies comprised adults who had undergone rotator cuff repair procedures. The outcomes of interest were functional outcomes (such as range of motion), pain scores, patient-reported outcome measures, and complication rates (such as re-repair and readmission rates). We applied random-effects models and calculated pooled effect sizes reported as standardized mean differences (SMDs) or relative risks (RRs) with 95% confidence intervals.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>We analysed data from 11 studies. In most, the follow-up periods ranged from 12 to 60 months. Obese individuals experienced greater pain (SMD 0.30; 95% CI, 0.10, 0.50) and lower shoulder function (SMD -0.33; 95% CI, -0.54, -0.12) than other individuals in the long-term post-operative follow-up. Obese individuals also had higher risks of complications (RR 1.48; 95% CI, 1.11, 1.98) and readmission (RR 1.35; 95% CI, 1.27, 1.43), but a similar likelihood of re-repair (RR, 1.27; 95% CI, 0.82, 1.95) than non-obese\/normal BMI individuals. While the forward flexion and external rotation functions were comparable, obese individuals displayed less internal rotation function than other individuals (SMD -0.59; 95% CI, -0.87, -0.30).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Obesity was associated with unfavourable outcomes after rotator cuff surgery, including increased pain, reduced shoulder function, high risks of complications, and readmission. These findings emphasize the importance of addressing obesity-related factors to improve post-operative outcomes.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0299125","type":"journal-article","created":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T17:41:04Z","timestamp":1710351664000},"page":"e0299125","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Impact of obesity on outcomes of rotator cuff repair: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"19","author":[{"given":"Xiaojun","family":"Ma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9890-9505","authenticated-orcid":true,"given":"Jun","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,3,13]]},"reference":[{"key":"pone.0299125.ref001","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1007\/s40273-014-0243-x","article-title":"The Epidemiology of Obesity: A Big Picture","volume":"33","author":"A Hruby","year":"2015","journal-title":"Pharmacoeconomics"},{"key":"pone.0299125.ref002","doi-asserted-by":"crossref","first-page":"1669","DOI":"10.1016\/j.jse.2014.03.016","article-title":"The association between body fat and rotator cuff tear: the influence on rotator cuff tear sizes","volume":"23","author":"S Gumina","year":"2014","journal-title":"J Shoulder Elbow Surg"},{"key":"pone.0299125.ref003","article-title":"Influence of body mass index on severity of rotator cuff tears","author":"P-W Weng","year":"2023","journal-title":"J Shoulder Elbow Surg"},{"key":"pone.0299125.ref004","first-page":"1","article-title":"Rotator cuff tear: A detailed update","volume":"2","author":"V Pandey","year":"2015","journal-title":"Asia Pac J Sports Med Arthrosc Rehabil Technol"},{"key":"pone.0299125.ref005","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1007\/s12178-018-9471-6","article-title":"Evaluation and Management of Rotator Cuff Tears: a Primary Care Perspective","volume":"11","author":"R Mathiasen","year":"2018","journal-title":"Curr Rev Musculoskelet Med"},{"key":"pone.0299125.ref006","first-page":"e27450","article-title":"The Impact of Obesity on Total Hip Arthroplasty Outcomes: A Retrospective Matched Cohort Study","volume":"14","author":"VA Aggarwal","year":"2022","journal-title":"Cureus"},{"key":"pone.0299125.ref007","doi-asserted-by":"crossref","first-page":"137","DOI":"10.5312\/wjo.v6.i1.137","article-title":"Overweight and obesity in hip and knee arthroplasty: Evaluation of 6078 cases","volume":"6","author":"D Guenther","year":"2015","journal-title":"World J Orthop"},{"key":"pone.0299125.ref008","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1016\/j.arth.2013.02.011","article-title":"Obesity and total joint arthroplasty: a literature based review","volume":"28","author":"Workgroup of the American Association of Hip and Knee Surgeons Evidence Based Committee","year":"2013","journal-title":"J Arthroplasty"},{"key":"pone.0299125.ref009","doi-asserted-by":"crossref","first-page":"S351","DOI":"10.1016\/j.otsr.2015.09.001","article-title":"Arthroscopy and obesity","volume":"101","author":"G Nourissat","year":"2015","journal-title":"Orthop Traumatol Surg Res"},{"key":"pone.0299125.ref010","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1111\/j.1467-789X.2006.00251.x","article-title":"Musculoskeletal disorders associated with obesity: a biomechanical perspective.","volume":"7","author":"SC Wearing","year":"2006","journal-title":"Obes Rev"},{"key":"pone.0299125.ref011","first-page":"e22711","article-title":"Obesity: A Chronic Low-Grade Inflammation and Its Markers","volume":"14","author":"D Khanna","year":"2022","journal-title":"Cureus"},{"key":"pone.0299125.ref012","doi-asserted-by":"crossref","first-page":"851","DOI":"10.5114\/aoms.2016.58928","article-title":"Obesity and inflammation: the linking mechanism and the complications","volume":"13","author":"MS Ellulu","year":"2017","journal-title":"Arch Med Sci"},{"key":"pone.0299125.ref013","doi-asserted-by":"crossref","first-page":"1839","DOI":"10.1097\/CORR.0000000000001261","article-title":"Obesity Increases the Risk of Tendinopathy, Tendon Tear and Rupture, and Postoperative Complications: A Systematic Review of Clinical Studies","volume":"478","author":"M Macchi","year":"2020","journal-title":"Clin Orthop Relat Res"},{"key":"pone.0299125.ref014","unstructured":"PRISMA. 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