PMID- 34419023
OWN - NLM
STAT- MEDLINE
DCOM- 20210824
LR  - 20210826
IS  - 1471-2474 (Electronic)
IS  - 1471-2474 (Linking)
VI  - 22
IP  - 1
DP  - 2021 Aug 21
TI  - Surgical outcome following rotator cuff tear repair in a low-income population. 
      Impact of obesity and smoking.
PG  - 714
LID - 10.1186/s12891-021-04599-6 [doi]
LID - 714
AB  - BACKGROUND: Comorbidities 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. METHODS: This 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. 
      RESULTS: Patients 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). CONCLUSIONS: Our 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.
CI  - (c) 2021. The Author(s).
FAU - Silva, Christine M M
AU  - Silva CMM
AUID- ORCID: 0000-0002-9912-8105
AD  - Postgraduating Program in Surgery, Faculdade de Medicina da Universidade Federal 
      do Ceara, Fortaleza, Brazil.
AD  - Orthopaedic Service - Shoulder and Elbow Group - Hospital Geral de Fortaleza, 
      Fortaleza, CE, Brazil.
FAU - Mourao, Natalia M
AU  - Mourao NM
AUID- ORCID: 0000-0001-5389-0842
AD  - Orthopaedic Service - Shoulder and Elbow Group - Hospital Geral de Fortaleza, 
      Fortaleza, CE, Brazil.
FAU - da Rocha, Leila N
AU  - da Rocha LN
AUID- ORCID: 0000-0002-2303-9392
AD  - Department of Internal Medicine, Faculdade de Medicina da Universidade Federal do 
      Ceara, Fortaleza, Brazil.
FAU - Landim, Joaquim I V D
AU  - Landim JIVD
AUID- ORCID: 0000-0003-3237-2573
AD  - Department of Internal Medicine, Faculdade de Medicina da Universidade Federal do 
      Ceara, Fortaleza, Brazil.
FAU - Rocha, Hermano A L
AU  - Rocha HAL
AUID- ORCID: 0000-0001-9096-0969
AD  - Department of Maternal and Child Health, Faculdade de Medicina, Universidade 
      Federal do Ceara, Fortaleza, Brazil.
AD  - Department of Global Health and Population, Harvard T. H. Chan School of Public 
      Health, Boston, MA, USA.
FAU - Lacerda, Marco A A
AU  - Lacerda MAA
AUID- ORCID: 0000-0002-4232-085X
AD  - Orthopaedic Service - Shoulder and Elbow Group - Hospital Geral de Fortaleza, 
      Fortaleza, CE, Brazil.
FAU - Rocha, Francisco A C
AU  - Rocha FAC
AUID- ORCID: 0000-0003-4370-3294
AD  - Department of Internal Medicine, Faculdade de Medicina da Universidade Federal do 
      Ceara, Fortaleza, Brazil. arocha@ufc.br.
AD  - Instituto de Biomedicina - Laboratorio de Investigacao em Osteoartropatias, Rua 
      Cel. Nunes de Melo, 1315 - 1 degrees . Andar, Rodolfo Teofilo -, Fortaleza, CE, 
      60430-270, Brazil. arocha@ufc.br.
FAU - Leite, Jose A D
AU  - Leite JAD
AUID- ORCID: 0000-0002-1231-3368
AD  - Department of Surgery, Faculdade de Medicina da Universidade Federal do Ceara, 
      Fortaleza, Brazil.
LA  - eng
PT  - Journal Article
DEP - 20210821
PL  - England
TA  - BMC Musculoskelet Disord
JT  - BMC musculoskeletal disorders
JID - 100968565
SB  - IM
MH  - Aged
MH  - Arthroscopy
MH  - Female
MH  - Humans
MH  - Middle Aged
MH  - Obesity/diagnosis/epidemiology
MH  - Poverty
MH  - *Rotator Cuff Injuries/epidemiology/surgery
MH  - Smoking
MH  - Treatment Outcome
PMC - PMC8380319
OTO - NOTNLM
OT  - Metabolic disease
OT  - Obesity
OT  - Outcome
OT  - Rotator cuff tear
OT  - Shoulder
OT  - Smoking
COIS- The author and co-authors declare that there are no conflicts of interest to 
      disclose concerning the publication of this article.
EDAT- 2021/08/23 06:00
MHDA- 2021/08/25 06:00
PMCR- 2021/08/21
CRDT- 2021/08/22 20:26
PHST- 2021/02/25 00:00 [received]
PHST- 2021/08/03 00:00 [accepted]
PHST- 2021/08/22 20:26 [entrez]
PHST- 2021/08/23 06:00 [pubmed]
PHST- 2021/08/25 06:00 [medline]
PHST- 2021/08/21 00:00 [pmc-release]
AID - 10.1186/s12891-021-04599-6 [pii]
AID - 4599 [pii]
AID - 10.1186/s12891-021-04599-6 [doi]
PST - epublish
SO  - BMC Musculoskelet Disord. 2021 Aug 21;22(1):714. doi: 10.1186/s12891-021-04599-6.