Surgery Outcomes Better when High Cholesterol and LDL are Under Control

Patients with moderate to high total cholesterol and low-density lipoprotein levels are at a significantly increased risk for failure of arthroscopic rotator cuff repair requiring revision surgery, researchers reported at the 2017 annual meeting of the American Academy of Orthopaedic Surgeons (AAOS) in San Diego this week. 

While there have been studies in animals that describe an association between elevated serum lipid profiles and the development of rotator cuff disease, there have been no known studies or analysis in humans.

In this study, researchers analyzed the records for patients undergoing arthroscopic rotator cuff repair between 2007 and 2014.  They evaluated the association of hyperlipidemia with failure of arthroscopic rotator cuff repair requiring revision surgery in a large cohort of patients. Secondarily, they assessed whether statin use mitigated the effects of hyperlipidemia.

A total of 13,164 patients had perioperative total cholesterol levels, 12,337 had low-density lipoprotein levels, and 13,230 patients had triglyceride levels. Patients with moderate or high total cholesterol or low-density lipoprotein levels had a significantly higher rate of revision surgery compared to patients with normal total cholesterol or low-density lipoprotein levels.

Much of this observed difference was due to patients not prescribed statins, as those patients with moderate or high total cholesterol or low-density lipoprotein levels who were prescribed statins, had revision rates that were not significantly different from patients with normal levels, the researchers stated.

“Statin use appears to mitigate this effect, as even among patients with moderate or high perioperative total cholesterol and LDL levels, those prescribed statins did not have a significantly higher risk of requiring revision surgery,” researchers wrote.