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Patient-Related Risk Factors Predict Outcomes After Arthroscopic Rotator Cuff Repair.

Joseph Cline1, Dmitri Falkner1, Tyler Brolin1

  • 1University of Tennessee - Campbell Clinic, Department of Orthopaedic Surgery and Biomedical Engineering, Memphis, Tennessee.

Journal of Surgical Orthopaedic Advances
|May 30, 2024
PubMed
Summary

Preoperative smoking negatively impacts rotator cuff surgery outcomes, leading to worse pain and function. Addressing smoking and opioid use before surgery can optimize results for patients undergoing rotator cuff repair.

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Area of Science:

  • Orthopaedic Surgery
  • Sports Medicine
  • Patient Outcomes Research

Background:

  • Rotator cuff tears are common, affecting shoulder function and quality of life.
  • Optimizing patient selection and preoperative factors is crucial for successful surgical outcomes.
  • Arthroscopic rotator cuff repair is a standard treatment, but patient-specific variables may influence results.

Purpose of the Study:

  • To investigate the association between preoperative patient characteristics and outcomes after primary arthroscopic rotator cuff repair.
  • To identify modifiable risk factors that could be addressed to improve patient results.
  • To evaluate the impact of smoking, alcohol, opioid use, obesity, and other factors on pain and function.

Main Methods:

  • Retrospective review of 75 primary arthroscopic rotator cuff repairs with minimum 2-year follow-up.

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  • Analysis of preoperative variables including tobacco, opioid, and alcohol use, obesity, mood disorders, disability claims, and Workers' Compensation status.
  • Assessment of outcomes using visual analog pain scores, American Shoulder and Elbow Surgeons (ASES) scores, Single Assessment Numeric Evaluation (SANE) scores, range of motion, and strength.
  • Main Results:

    • Preoperative smoking was significantly linked to worse pain, ASES, and SANE scores.
    • No significant difference in pain or function was observed with preoperative opioid use.
    • Preoperative alcohol use was associated with improved ASES scores at long-term follow-up.
    • Other studied variables did not demonstrate a significant association with inferior outcomes.

    Conclusions:

    • Preoperative smoking is a significant negative predictor of pain and functional outcomes following arthroscopic rotator cuff repair.
    • While preoperative opioid use did not show a significant negative impact in this cohort, it remains a potential area for optimization.
    • Alcohol consumption may be associated with better long-term shoulder function after repair.
    • Identifying and modifying preoperative risk factors like smoking can enhance surgical success rates for rotator cuff repair.