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High cholesterol levels linked to rotator cuff surgery failure

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Patients with higher cholesterol levels are more likely to need revision surgery after arthroscopic rotator cuff repair, according to a recent study.

Researchers found that patients with moderate or high cholesterol levels faced a “significantly increased risk” for failure of rotator cuff surgery. However, the research also showed that commonly used cholesterol lowering drugs, called statins, diminish this risk.

The findings were presented at last week’s annual meeting of the American Academy of Orthopaedic Surgeons (AAOS).

For the study, researchers reviewed a private insurer patient database of nearly 31,000 patients who underwent arthroscopic rotator cuff repair between 2007 and 2014. Patients were divided into normal, moderate and high cholesterol groups, based on: their total cholesterol levels (the measure of low-density lipoprotein [LDL], also known as “bad” cholesterol, and high-density lipoprotein [HDL], or “good cholesterol”); LDL levels alone; and triglycerides, another form of fat in the blood that increases the risk of heart disease. Researchers also looked at whether or not the patients took statins before and after surgery.

The results showed:

* The rate of revision rotator cuff surgery was significantly increased in patients with moderate or high total cholesterol and LDL levels compared to patients with normal levels.

* Among the patients with moderate or high cholesterol, those who were not taking statins before or after surgery had significantly higher rates of revision surgery.

* Patients taking statins before or after surgery did not have higher rates of revision surgery, even if their cholesterol levels were high.

* Triglyceride levels had no impact on rotator cuff surgery outcomes.

Lead author Dr Brian C. Werner, an orthopaedic surgeon at the University of Virginia School of Medicine, said that further research is needed into the association between statins and rotator cuff surgical outcomes to find out whether improved cholesterol control can improve clinical outcomes following arthroscopic rotator cuff repair.