The Impact of Systemic Metabolic Disorders on Rotator Cuff Tears and Surgical Outcomes
10.4055/jkoa.2026.61.1.38
- Author:
Sung-Jin PARK
1
;
Jong Pil YOON
;
Seok Won CHUNG
Author Information
1. Department of Orthopaedic Surgery, Kyungpook National University Hospital, Daegu, Korea
- Publication Type:Review
- From:The Journal of the Korean Orthopaedic Association
2026;61(1):38-49
- CountryRepublic of Korea
- Language:English
-
Abstract:
Rotator cuff tears are a common musculoskeletal disorder that significantly impairs shoulder function, especially in the elderly. Traditionally, mechanical wear and age-related degeneration have been considered the leading causes. Recent studies, however, emphasize that systemic metabolic disorders, such as diabetes mellitus, obesity, and dyslipidemia, play a crucial role in the development and healing of rotator cuff disease. This narrative review comprehensively examines the biological mechanisms and clinical outcomes associated with these metabolic comorbidities in rotator cuff degeneration and surgical repair failure. Based on relevant clinical and experimental studies, this study analyzed how each metabolic disease contributes to tendon injury and impaired regeneration. Diabetes mellitus induces chronic inflammation, inhibits collagen synthesis, and impairs microvascular perfusion, hindering tendon healing. Obesity increases the mechanical load on the shoulder and promotes systemic inflammation, exacerbating fatty infiltration of muscles and delaying tissue repair. Dyslipidemia accelerates tendon degeneration through the accumulation of fat, oxidative stress, and fatty infiltration of the rotator cuff muscles. These systemic factors are associated with higher re-tear rates, delayed functional recovery, and poorer surgical outcomes. As the prevalence of metabolic syndrome increases, precise assessment and perioperative management of these metabolic disorders are essential to improve patient outcomes and develop personalized treatment strategies for rotator cuff tears.
