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Smokers Benefit From Rotator Cuff Repair

Smokers Benefit From Rotator Cuff Repair

Kirsten Lundgreen, MD, PhD, NORWAY Christian Owesen, MD, PhD, NORWAY Sigbjorn Dimmen, Prof., MD, PhD, NORWAY Kjersti Kaul Jenssen, MD, PhD, NORWAY

Lovisenberg Diaconal Hospital, Oslo, 133, NORWAY


2021 Congress   ePoster Presentation     rating (1)

 

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Sports Medicine

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Summary: 70% of smokers demonstrate functional benefit exceeding the MIC following rotator cuff repair according to the WORC index at 2-year follow-up


Introduction

Smoking is associated with increased tendon degeneration, larger rotator cuff tears and inferior results following rotator cuff repair. The purpose of this study was to report our experience with rotator cuff repair in smokers compared to non-smokers.

Methods

733 consecutive patients underwent arthroscopic rotator cuff repair in our orthopaedics unit between 2010 and 2014. Data were collected prospectively. 647 patients (88%) completed a 2-year follow up; 62 were active smokers and 588 were non-smokers. We compared their functional results after a mean of 25 months (SD±5) with WORC index and Constant Murley (CM) score. Tendon healing was evaluated according to Sugaya with MRI in 444(68.6%) patients at a mean of 21 months (SD±13).

Results

Tear size and preoperative functional scores did not differ between the groups. Non-smokers reported a greater proportion of traumatic tears: 59% vs 47% in smokers (p=.02). The functional improvement after rotator cuff repair at 2-year follow up was inferior among smokers compared to non-smokers: CM-score increase 36.9 vs 45.1 (p=.002), and WORC index increase 30.3 vs 37.7 (p=.009). 70% of smokers demonstrated functional benefit from rotator cuff repair with WORC index gain exceeding minimal important change (MIC; 13 points) compared to 87% of non-smokers (p<.001). Healing rate on postoperative MRI was 82% among smokers and 81% among non-smokers. One (1.4%) smoker and 9 (1.4%) non-smokers developed postoperative infection. All responded well to arthroscopic debridement and antibiotics.

Conclusion

Rotator cuff repair in smokers was associated with inferior results compared to non-smokers. 70% of smokers demonstrated functional benefit exceeding the MIC following rotator cuff repair according to the WORC index at 2-year follow-up.


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