Obesity No Barrier For Shoulder Replacement Surgery, Study Finds

Key Takeaways

• People with obesity shouldn’t be rejected outright for shoulder replacement surgery

• Researchers found those with high BMI fared as well or better following the surgery than folks with a healthy weight

• Underweight people had the worst outcomes

FRIDAY, Nov. 21, 2025 (HealthDay News) — Obesity shouldn’t be considered a barrier for a patient who needs shoulder replacement surgery, a new study argues.

In some places, doctors have been denying joint replacement surgery to people with a high body-mass index, due to concerns over their ability to recover from the procedure, researchers said in background notes.

But patients with obesity actually have a lower risk of death following the surgery than patients at a healthy weight, researchers reported Nov. 20 in the journal PLOS Medicine.

They also had about the same risk of suffering serious complications or needing follow-up surgery, researchers found.

In fact, underweight patients fared worst following shoulder replacement surgery, results show.

“While BMI thresholds have been used to limit access to joint replacement surgery, our findings do not support restricting higher BMI patients from accessing shoulder replacement surgery,” senior researcher Dr. Jonathan Rees, director of the Botnar Institute for Musculoskeletal Sciences at the University of Oxford, said in a news release.

Even though medical societies have offered no formal recommendations regarding a patient’s weight and joint replacement surgery, previous studies have found that in some countries access to these procedures is restricted based on BMI, researchers said in background notes.

For this new study, researchers tracked nearly 21,000 patients who underwent shoulder replacement surgery in the United Kingdom and Denmark.

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Results showed that people with obesity had a 60% lower risk of death within a year of the surgery compared to those with a healthy weight.

By comparison, underweight people had a 69% increased risk of death within 90 days of the surgery, as well as a 36% higher risk of serious complications and 70% higher odds of needing follow-up surgery. A BMI of less than 18.5 is considered underweight.

The study’s findings are limited because few people with a high BMI got shoulder surgery — 131 in the U.K and 70 in Denmark.

But researchers argue that the large study consistently showed that obese people had a lower risk of death in two different countries.

“Shoulder replacements offer patients the opportunity for excellent pain relief and improved quality of life,” lead researcher Dr. Epaminondas Markos Valsamis, a research fellow with the University of Oxford, said in a news release. “Our research shows that patients with a higher BMI do not have poorer outcomes after shoulder replacement surgery.”

More information

Massachusetts General Hospital has more on shoulder replacement surgery.

SOURCES: PLOS, news release, Nov. 20, 2025; PLOS Medicine, Nov. 20, 2025

What This Means For You

People with obesity are likely to fare as well as people with healthy weight following shoulder replacement surgery.