Effect of Smoking on Postoperative Function and Quality of Life After Full Thickness Arthroscopic Rotator Cuff Repair: A Retrospective Analysis

Abstract

Purpose: The effect of smoking on preoperative and postoperative outcome scores as well as quality of life measurements after arthroscopic rotator cuff repair (ARCR) has not been fully understood, and studies regarding this are lacking in the literature. This study aimed to evaluate the effect of smoking on function and quality of life after ARCR. Methods: Two-hundred patients who underwent full-thickness ARCR with a minimum 1-year follow-up period were included and evaluated retrospectively. The patients were divided into two groups: smokers (Group 1, 59 patients) and nonsmokers (Group 2, 141 patients). Pre- and postoperative Constant Murley (CM) scores, American Shoulder and Elbow Surgeons (ASES) scores, visual analogue scale scores (VASs), and Short-Form 36 health survey (SF-36) scores were used to evaluate functional and quality of life outcomes. The correlation between the smoking amount (pack-years) and outcomes was evaluated. Results: A total of 200 patients included into study (90 male and 110 female) with mean age of 62.68 ± 3.98. There was no statistically significant difference between the two groups regarding preoperative scores, except in the ASES score (P = 0.021) Additionally, there was a statistically significant difference between the groups regarding postoperative CM score, ASES score, and VAS, and in physical functioning and role limitations due to physical health domains of the SF-36 (P = 0.029, P = 0.038, P = 0.021 and P = 0.020, respectively). There were small to moderate negative correlations between amount of smoking and preoperative physical functioning, role limitations from emotional problems, energy/fatigue, emotional well-being, and pain domains of the SF-36. However, there were moderate to strong negative correlations between amount of smoking and postoperative SF-36 domains. Conclusion: Preoperative and postoperative functional outcome scores, and quality of life measurements are negatively affected from smoking. As the amount of smoking increases, postoperative results are negatively affected. Level of evidence: 3.