Original Article

Clinical Orthopaedics and Related Research®

, Volume 468, Issue 6, pp 1534-1541

First online:

Cigarette Smoking Increases the Risk for Rotator Cuff Tears

  • Keith M. BaumgartenAffiliated withOrthopedic Institute Email author 
  • , David GerlachAffiliated withDepartment of Orthopaedic Surgery, Washington University School of Medicine
  • , Leesa M. GalatzAffiliated withDepartment of Orthopaedic Surgery, Washington University School of Medicine
  • , Sharlene A. TeefeyAffiliated withDepartment of Diagnostic Radiology, Washington University School of Medicine, MIR Institute of Radiology
  • , William D. MiddletonAffiliated withDepartment of Diagnostic Radiology, Washington University School of Medicine, MIR Institute of Radiology
  • , Konstantinos DitsiosAffiliated withDepartment of Diagnostic Radiology, Washington University School of Medicine, MIR Institute of Radiology
  • , Ken YamaguchiAffiliated withDepartment of Orthopaedic Surgery, Washington University School of Medicine

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Abstract

There is little available evidence regarding risk factors for rotator cuff tears. Cigarette smoking may be an important risk factor for rotator cuff disease. The purpose of this study was to determine if cigarette smoking correlates with an increased risk for rotator cuff tears in patients who present with shoulder pain. A questionnaire was administered to 586 consecutive patients 18 years of age or older who had a diagnostic shoulder ultrasound for unilateral, atraumatic shoulder pain with no history of shoulder surgery. Three hundred seventy-five patients had a rotator cuff tear and 211 patients did not. Data regarding cigarette smoking were obtained for 584 of 586 patients. A history of smoking (61.9% versus 48.3%), smoking within the last 10 years (35.2% versus 30.1%), mean duration of smoking (23.4 versus 20.2 years), mean packs per day of smoking (1.25 versus 1.10 packs per day), and mean pack-years of smoking (30.1 versus 22.0) correlated with an increased risk for rotator cuff tear. We observed a dose-dependent and time-dependent relationship between smoking and rotator cuff tears. We observed a strong association between smoking and rotator cuff disease. This may indicate smoking is an important risk factor for the development of rotator cuff tears.

Level of Evidence: Level III, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.