Does high body mass index increase the risk of shoulder instability surgery? The LUXE prospective cohort study on 227 recurrent anterior shoulder instability

Background: The aim of this study was to determine whether body mass index (BMI) plays a role in overall morbidity following shoulder instability surgery and whether some surgical techniques are BMI-sensitive. Methods: A prospective, multicenter database was created that included the following three surgical techniques: arthroscopic Bankart (AB), arthroscopic Bankart with remplissage (ABR), and Open Latarjet (OL). Patient data (demographic, strength, laxity and functional outcomes (Disability of the Arm, Shoulder, and Hand [QuickDASH]; Western Ontario Shoulder Instability Index; and QuickDASH Pain subscore) were compared at enrollment and last postoperative follow-up. Functional outcomes, complications, and postoperative outcomes were compared between the different groups and then subdivided by BMI. Follow-up radiographs were evaluated for graft position and complications for all patients who underwent OL. Results: A total of 227 patients (164 men, 63 women) were included with at least 1-year follow-up (3.3y AB (n = 126), 4.5y ABR (n = 34), and 3y OL (n = 62)). At baseline, patients with high BMI (37(17%)) had significantly worse QuickDASH Pain subscores (2.9 ± 1.0, P value