Rotator cuff repair in patients with type I diabetes mellitus☆

Abstract 

Insulin-dependent diabetes mellitus is associated with shoulder stiffness and a propensity toward postoperative wound complications and infection. We compared our results of open repair of full-thickness rotator cuff tears in 30 diabetic patients with those of a matched, nondiabetic population. No differences were observed in preoperative range of motion, although at a mean of 34 months, significant differences in shoulder active range of motion and passive range of motion were found postoperatively at 6 weeks, 6 months, and final follow-up (P < .05). On the basis of American Shoulder and Elbow Surgeons shoulder scoring, there were 27 (90%) and 28 (93%) good or excellent results in the diabetic and comparison groups, respectively. Complications occurred in 5 diabetic patients (17%), with 2 failures (7%) and 3 infections (10%), as compared with 1 failure (3%) and no infections in the comparison group. Repair of the diabetic rotator cuff may be performed with the expectation of improved motion and function, although less than nondiabetic counterparts. The surgeon should remain cognizant that a higher rate of complications, infection in particular, may occur after rotator cuff repair in the diabetic population.