Surgical outcome following rotator cuff tear repair in a low-income population. Impact of obesity and smoking

BMC Musculoskeletal Disorders

Joaquim I. V. D. Landim¹  Leila N. da Rocha¹  Francisco A. C. Rocha²  Hermano A. L. Rocha³  José A. D. Leite⁴  Natália M. Mourão⁵  Marco A. A. Lacerda⁵  Christine M. M. Silva⁶ 

[1] Department of Internal Medicine, Faculdade de Medicina da Universidade Federal do Ceará, Fortaleza, Brazil;Department of Internal Medicine, Faculdade de Medicina da Universidade Federal do Ceará, Fortaleza, Brazil;Instituto de Biomedicina – Laboratório de Investigação em Osteoartropatias, Rua Cel. Nunes de Melo, 1315 - 1°. Andar, Rodolfo Teófilo –, 60430-270, Fortaleza, CE, Brazil;Department of Maternal and Child Health, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, Brazil;Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA;Department of Surgery, Faculdade de Medicina da Universidade Federal do Ceará, Fortaleza, Brazil;Orthopaedic Service – Shoulder and Elbow Group – Hospital Geral de Fortaleza, Fortaleza, CE, Brazil;Postgraduating Program in Surgery, Faculdade de Medicina da Universidade Federal do Ceará, Fortaleza, Brazil;Orthopaedic Service – Shoulder and Elbow Group – Hospital Geral de Fortaleza, Fortaleza, CE, Brazil;

关键词: Shoulder;    Rotator cuff tear;    Metabolic disease;    Obesity;    Smoking;    Outcome;   

DOI  :  10.1186/s12891-021-04599-6

来源: Springer

【 摘 要 】

BackgroundComorbidities 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.MethodsThis 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.ResultsPatients 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).ConclusionsOur 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.

【 授权许可】

CC BY