Worse Postoperative Outcomes and Higher Reoperation in Smokers Compared to Nonsmokers for Arthroscopic Rotator Cuff Repair
Institution / Department
Henry Ford Health, Department of Orthopaedic Surgery
Level of Research
Introduction: Smoking impairs healing potential and is a significant risk factor for complications following orthopaedic surgeries. The purpose of this study was to determine if a cohort of former or current smokers at time of surgery met the minimally clinical important difference (MCID) for Patient-Reported Outcomes Measurement Information System Upper Extremity (PROMIS-UE), Depression (PROMIS-D), and Pain Interference (PROMIS-PI) scores in comparison to nonsmokers.
Methods: A retrospective review of patients who underwent rotator cuff repair was performed. Patients who completed preoperative and 6-month postoperative PROMIS scores were included. The MCID was calculated using a distribution technique with a threshold of 0.5 standard deviations above the mean. A cohort of nonsmokers was compared to current/former smokers in terms of clinical outcomes and PROMIS scores.
Results: A total of 182 patients, 80 current/former smokers and 102 nonsmokers, were included. Smokers had significantly more massive-sized tears and more reoperations (16.3% vs 5.9%,P=0.02). No differences were found in change in PROMIS scores, proportion meeting MCID for PROMIS scores, and retear rate. In the sub-analysis, 74 current/former smokers were matched to 74 nonsmokers. Smokers had lower change in PROMIS-UE (8.6±9.8 vs 12.3±10.0,P=0.007) and PROMIS-PI (-9.1±8.5 vs -12.8±10.1,P=0.03) postoperatively. Fewer met MCID for PROMIS UE postoperatively (60.3% vs 82.4%,P=0.003) and more had reoperations (16.2% vs 4.1%,P=0.02).
Conclusion: Smokers or former smokers demonstrated smaller improvements in function, pain scores, and were less likely to meet MCID for PROMIS-UE when compared to nonsmokers after arthroscopic rotator cuff repair. Smokers were more likely to undergo reoperations within 6 months.
Community Health | Community Health and Preventive Medicine | Medicine and Health Sciences | Musculoskeletal Diseases | Musculoskeletal, Neural, and Ocular Physiology | Orthopedics | Sports Medicine | Substance Abuse and Addiction | Surgery
Wager, Susan G.; Brown, Spencer; Gaudiani, Michael; Castle, Joshua P.; Jiang, Eric; Moutzouros, Vasilios; Makhni, Eric; and Muh, Stephanie J., "Worse Postoperative Outcomes and Higher Reoperation in Smokers Compared to Nonsmokers for Arthroscopic Rotator Cuff Repair" (2023). Medical Student Research Symposium. 280.
Community Health Commons, Community Health and Preventive Medicine Commons, Musculoskeletal Diseases Commons, Musculoskeletal, Neural, and Ocular Physiology Commons, Orthopedics Commons, Sports Medicine Commons, Substance Abuse and Addiction Commons, Surgery Commons