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September 1, 2026Orthopaedic Journal of Sports MedicineOpen Access

Hyperlipidemia is linked to higher risk of repeat rotator cuff repair up to 5 years.

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Why the study?

Conflicting evidence exists regarding the role of hyperlipidemia and statin therapy in tendon-to-bone healing after arthroscopic rotator cuff repair.

Does hyperlipidemia increase the risk of secondary procedures in adults undergoing primary arthroscopic rotator cuff repair?

Population

144,555 adults undergoing primary arthroscopic rotator cuff repair

Comparison

Hyperlipidemia with or without perioperative statins vs no hyperlipidemia

Design

Retrospective propensity score-matched cohort study

Follow-up

Up to 5 years

Key result

Hyperlipidemia was consistently associated with higher risks of repeat rotator cuff repair and shoulder debridement at all time points up to 5 years after primary arthroscopic repair (p < 0.05).

Authors

OPOmkar PrabhavalkarNMNicholas MorrissMMMichaela Malin

Discussion

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Overview

Hyperlipidemia may warrant closer postoperative surveillance after rotator cuff repair; extends prior associations but leaves causal role and interventions open.

Key Points

  • To assess whether hyperlipidemia and perioperative statin use increase the risk of secondary surgical procedures, including repeat repair and total shoulder arthroplasty, after primary arthroscopic rotator cuff repair.
  • Retrospective cohort analysis of 144,555 adult patients undergoing primary arthroscopic rotator cuff repair between 2015 and 2020 using the multi-institutional TriNetX Research Network.
  • Patients were categorized by hyperlipidemia diagnosis, perioperative statin use, and total cholesterol/LDL levels, followed by 1:1 propensity score matching (40,430 matched pairs).
  • Primary and secondary outcomes—including revision rotator cuff repair, debridement, lysis of adhesions, and conversion to total shoulder arthroplasty—were tracked over 6 months to 5 years.
  • Propensity-matched hyperlipidemia patients experienced significantly higher rates of repeat rotator cuff repair and debridement across all time points (p < 0.05), total shoulder arthroplasty at 3 (p = 0.024) and 5 years (p < 0.001), and lysis of adhesions at 1, 3, and 5 years (p < 0.05).
  • Total cholesterol categories (<200, 200–239, >240 mg/dL) did not correlate with most secondary procedures, except for increased manipulation under anesthesia in the 200–239 mg/dL group (p = 0.016).
  • Among patients with low cholesterol, perioperative statin use was associated with higher 3-year risks of repeat rotator cuff repair (p = 0.014) and shoulder arthroplasty (p = 0.008).

Study Design

Type

Cohort (n=144,555)

Multicenter

Yes

Structured PICO

Does hyperlipidemia increase the risk of secondary procedures in adults undergoing primary arthroscopic rotator cuff repair?

P
Population
144,555 adults undergoing primary arthroscopic rotator cuff repair, categorized by hyperlipidemia status and perioperative statin use, followed for up to 5 years.
E
Exposure
Hyperlipidemia (with or without perioperative statin use from 90 days before to 90 days after surgery)
C
Comparator
No diagnosis of hyperlipidemia
O
Outcome
Subsequent rotator cuff repair identified by CPT 29827 at 6 months, 1 year, 2 years, and 5 years postoperativelyhard clinical

Main Result

p-value: p=<0.05

Hyperlipidemia is associated with an increased risk of secondary procedures, including repeat repair and arthroplasty, following primary arthroscopic rotator cuff repair.

Cite This Study

Prabhavalkar et al. (2026) conducted a cohort in Primary arthroscopic rotator cuff repair (n=144,555). Hyperlipidemia vs. No diagnosis of hyperlipidemia was evaluated on Subsequent rotator cuff repair (p=<0.05). Hyperlipidemia was consistently associated with higher risks of repeat rotator cuff repair and shoulder debridement at all time points up to 5 years after primary arthroscopic repair (p < 0.05).

synapsesocial.com/papers/6a969a7f535111e2d4ce8cb6https://doi.org/10.1177/2325967126s00518
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