Statin therapy is not associated with inferior postoperative outcomes after arthroscopic rotator cuff repair: a systematic review and meta-analysis.

In 30 seconds

This systematic review and meta-analysis compared postoperative outcomes after arthroscopic rotator cuff repair (ARCR) in statin users and non-users. It included seven observational studies (one Level II and six Level III), with 7,653 statin users and 6,830 controls. Retear rates did not differ significantly (risk ratio = 1.14; 95% confidence interval [CI], 0.54-2.42; P = .73), and functional outcomes were comparable. Statin use was associated with lower revision surgery risk (risk ratio = 0.83; 95% CI, 0.70-1.00; P = .04), although this result was heavily weighted by a large administrative database study.

Key findings

• Retear rates were not significantly different between statin users and non-users (risk ratio = 1.14; 95% CI, 0.54-2.42; P = .73).
• Revision surgery risk was lower among statin users (risk ratio = 0.83; 95% CI, 0.70-1.00; P = .04), with the analysis heavily weighted by one large administrative database study.
• American Shoulder and Elbow Surgeons scores and visual analog scale pain scores were comparable between groups.

Why it matters

The findings address concern that statin exposure might impair tendon healing or functional recovery after ARCR. Across the included studies, statin use was not associated with higher retear rates or worse reported function, while the observed lower revision rate warrants cautious interpretation. The review also highlights that underlying hyperlipidemia may be relevant to postoperative risk and merits further study.

What to keep in mind

The evidence comprised mostly Level III studies, and the lower revision risk finding was heavily weighted by a large administrative database study. The authors note that lipid-stratified studies are needed to clarify the relationship between dyslipidemia, statin therapy, and postoperative risk.