Smoking Affects Shoulder Surgery Outcomes

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Lisa Doty, [email protected]
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Smoking affects shoulder surgery outcomes

ORLANDO, Fla.--The success of shoulder surgery to repair a rotator cuff tear is greater among nonsmokers than smokers, according to a study presented here today at the 67th annual meeting of the American Academy of Orthopaedic Surgeons.

Researchers in Durham, N.C. and Indianapolis investigated the effects of smoking on 235 patients treated at two medical institutions and followed for a minimum of one year.

"The majority of nonsmokers--84 percent--had good/excellent results from their surgery," said study co-author Gary W. Misamore, MD, Methodist Sports Medicine Center, and clinical associate professor of orthopaedic surgery, Indiana University, Indianapolis. "In contrast, 35 percent of smokers had good/excellent results."

Smokers were in more pain than nonsmokers both before and after surgery. "Cigarette smoking has a detrimental effect on the healing of soft tissues and bone," said Dr. Misamore.

The researchers also analyzed whether the treatment of the patient's injury was covered by Worker's Compensation.

"Worker's compensation patients had poorer postoperative scores than those not filing worker's compensation claims," said Dr. Misamore, "but nonsmoker worker's comp patients had better scores than all smokers, regardless of worker's comp status."

For the study, Dr. Misamore and colleagues compared the outcomes of four patient groups: (1) nonsmoker/nonWorker's compensation, (2) nonsmoker/Worker's compensation, (3) smoker/nonWorker's compensation, (4) smoker/Worker's compensation.

Analysis revealed that the results in nonsmokers were better than in smokers at statistically significant levels. "These results demonstrate that smoking has a negative correlation with successful outcome following surgical repair of the rotator cuff," said Dr. Misamore.

The rotator cuff is the group of four shoulder muscles which enables a person to reach overhead, swing a baseball bat or pick up a bag of groceries.

Co-authors of the study with Dr. Misamore are Dale S. Snead, MD, staff surgeon at Methodist Sports Medicine Center, Indianapolis; William J. Mallon, MD, Triangle Orthopaedic Associates, PA, Durham, N.C.; Patrick K. Denton, MD, resident in orthopaedic surgery, Indiana University.

The 24,500-member American Academy of Orthopaedic Surgeons (http://www.aaos.org) is a not-for-profit organization that provides education programs for orthopaedic surgeons, allied health professionals and the public, and is an advocate for improved patient care.

In the first year of the United Nations-declared Bone and Joint Decade (2000-2010) (http://www.boneandjointdecade.org), the Academy is holding its annual meeting at the Orange County Convention Center, Orlando, March 15-19.

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