Background Comorbidities and socioeconomic issues impact outcome of rotator cuff tear (RCT) repair. There are no data on RCT repair outcome from developing regions. We determined the impact of obesity and smoking following RCT repair in a low-income population. Methods This is a retrospective case series. Forty-seven shoulders of 42 patients subjected to open or arthroscopic repair of a RCT with a minimum of 2 years follow-up were cross-sectionally evaluated. Patients were seen in the Orthopaedic Service of the Hospital Geral de Fortaleza-CE, Brazil between March and September 2018. RCT were classified as partial or full-thickness lesions. Fatty infiltration (Goutallier) and tendon retraction (Patte) were recorded as well as obesity (BMI > 30), literacy [>/≤ 8 school years (SY)] and smoking status 6 months prior to surgery (present/absent). Outcomes included pain (visual analogue scale; VAS, 0–10 cm), range of motion [active forward flexion and external rotation (ER)], UCLA and ASES scoring. Results Patients were 59.9 ± 7.4 years-old, 35(74.4%) female with 19 (17.1–30.2 IQR) median of months from diagnosis to surgery and 25 median months of follow-up (26.9–34.0 IQR); over 90% declared < 900.00 US$ monthly family income and two-thirds had ≤8 SY. Forty patients (85.1%) had full-thickness tears, 7 (14.9%) had Goutallier ≥3 and over 80% had < Patte III stage. Outcomes were similar regardless of fatty infiltration or tendon retraction staging. There were 17 (36.1%) smokers and 13 (27.6%) obese patients. Outcome was similar when comparing obese vs non-obese patients. Smokers had more pain (P = 0.043) and less ER (P = 0.029) with a trend towards worse UCLA and ASES scores as compared to non-smokers though differences did not achieve minimal clinically important difference (MCID) proposed for surgical RCT treatment. After adjusting for obesity, VAS and ER values in smokers were no longer significant (P = 0.2474 and 0.4872, respectively). Conclusions Our data document outcomes following RCT repair in a low-income population. Smoking status but not obesity impacted RCT repair outcome though not reaching MCID for surgical treatment.

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Background:Rotator cuff tears (RCT) rank high among causes of shoulder pain in primary care. Surgical repair of RCT is indicated when judged refractory to clinical treatment. Comorbidities and environmental issues may impact the surgical result of RCT repair.Objectives:to determine the impact of Obesity and Smoking in the outcome of low-income patients subjected to RCT repair.Methods:Low-income (<5500,00 US$ annualpib per capta*) patients living in Fortaleza-CE, Brazil were prospectively (2016-2018) evaluated in the Orthopedic and Rheumatology Services of the Hospital Geral de Fortaleza. Demographics and clinical data focusing Obesity (BMI >/≤ 30) and Smoking status (present/absent) were registered. Pain (0 – 10 cm VAS) and functional shoulder score evaluation by the University of California at Los Angeles Shoulder Score (UCLA) and American Shoulder and Elbow Surgeons (ASES) scoring systems following at least 2 years post-operative follow-up were recorded.Results:Thirty-nine individuals, 60.9±7.1 years-old, 30 female (68.3%) with 5.1 ± 1.9 years follow-up were evaluated; 21 (44.7%) were Smokers and 12 (25.5%) Obese (BMI >30). Other comorbidities included 16 arterial hypertension, 18 dyslipidemia, 17 osteoarthritis, 4 rheumatoid arthritis, 1 gout. Pain VAS values were 5.1 ± 2.6 vs 3.1 ± 2.8 in Obese vs Non-Obese (p=0.03) and 4 ± 2.8 vs 3.37 ± 2.99 in Smokers vs Non-Smokers (p=0.26), respectively. UCLA was 22.4 ± 8.2 vs. 28.79 ± 5.6 in Obese vs Non-Obese (p=0.004) and 26.2 ± 6.5 vs. 27.75 ± 7.18 (p=0.25) in Smokers vs. Non-smokers, respectively. ASES was 47.89 ± 28.3 vs. 68.1 ± 25.78 (p=0.021) in Obese vs. Non-obese and 58.98 ± 26.69 vs 65.3 ± 28.1 (p=0.243) in Smokers vs Non-Smokers, respectively.Conclusion:Using Patient Reported Outcome instruments, these long-term data show that Obesity negatively impacts the outcome of surgical repair of RCT in low-income patients. Smoking status was apparently irrelevant but the number of cigarettes smoked daily was not considered. Emphasis on weight reduction is a practical, affordable though hard to implement measure that could improve surgical results when repairing RCT.References:*https://pt.wikipedia.org/wiki/Lista_de_munic%C3%ADpios_do_Brasil_por_PIBDisclosure of Interests:Christine Silva: None declared, Natalia Mourão: None declared, Joaquim Landim: None declared, Leila da Rocha: None declared, Marco Lacerda: None declared, Airton Rocha Speakers bureau: Not related to the present work