Comparative Analysis on the Result for Arthroscopic Rotator Cuff Suture Between Smoking and Non-Smoking Patients

Abstract

Objective: To comparatively analyze the results from arthroscopic rotator cuff suture between smoking and non-smoking patients. Methods: A group of 286 patients who underwent arthroscopic suturing of primary rotator cuff injuries between June 12, 2002, and May 14, 2008, was analyzed. The patients included in the study were evaluated using the UCLA scale, with a minimum follow-up of 12 months and average of 56.52 months. The variables studied were age, sex, side operated, dominance, profile of cigarette use and UCLA index. Results: This study evaluated a total of 205 patients. Mean age (p = 0.289) and sex (p = 0.124) were analyzed statistically between the smoking and non-smoking patients and the two groups were considered to be similar. The average UCLA score for the non-smoking patients (143) was 34 (32 to 35). The average UCLA score for the smoking patients (51) was 33 (29 to 35). There was no statistically significant difference in UCLA score (p = 0.123) between the smoking and non-smoking patients. For the purposes of statistical analysis, we grouped the small and medium tears (107) and compared these with the large and extensive tears (80), between smokers and non-smokers. There was no statistically significant difference using the Mann-Whitney test regarding the small and medium tears (p = 818). There was a statistically significant difference using the Mann-Whitney test regarding the large and extended tears, between the smoking and non-smoking patients, such that the non-smokers showed better UCLA scores (p = 0.038). Conclusion: The results from arthroscopic suturing of large and extensive rotator cuff injuries are inferior among smoking patients.

Rotator cuff injuries and factors associated with reoperation

“…In the present study, among the 18 reoperations, only three (16.6%) were on smokers. Similarly to the data presented by Almeida et al, 20 two had massive lesions and one had a large lesion (cases 1, 5, and 7, respectively). Case 1 reported trauma as a causal factor of the recurrence of symptoms.…”

“…The influence of co-morbidities as indirect causes of healing impairment has been studied. Almeida et al 20 analyzed the relationship between smoking and failed arthroscopic suture in patients operated for RCI and reported that smokers have worse outcomes when compared to non-smokers, but only in case of large and massive lesions. In the present study, among the 18 reoperations, only three (16.6%) were on smokers.…”

Outcome assessment in the treatment of rotator cuff tear: what is utilized in Brazil?

“…In the period evaluated, 712 original articles were published in the Brazilian Journal of Orthopedics and 588 in Acta Ortopédica Brasileira, or 1300 publications. Among these, 84 (6.7% of the total) were clinical articles on shoulder diseases; 25 publications (1.9% of the total) 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 evaluated the clinical results of treatment of rotator cuff tears ( Table 1 ); twenty studies (80%) were case series (level of evidence IV), one (4%) case–control study (level of evidence III) and four (16%) cohorts (level of evidence II). No randomized study was published in the period.…”

Comparative analysis on arthroscopic sutures of large and extensive rotator cuff injuries in relation to the degree of osteopenia

“…However, most authors have shown that smoking has a deleterious effect on these patients’ microvascularization, healing and final clinical results. 7 , 8 , 9 , 10 , 36 , 37 In accordance with the trend among the majority of articles in the literature, we excluded smokers.…”

“…The patient's age at the time of the surgical procedure seems to have an influence on healing and on gains relating to range of motion and muscle strength. 3 , 4 Other variables such as sex, 5 smoking, 6 , 7 , 8 , 9 , 10 tendon quality shown on magnetic resonance imaging, 11 humerus-acromion distance <7 mm shown on X-rays 12 and impairment of the long head of the biceps have been considered to be deleterious for the final result from the treatment. 13 , 14 , 15 , 16 , 17 …”