Clinical Orthopaedics and Related Research®

, Volume 468, Issue 6, pp 1534–1541 | Cite as

Cigarette Smoking Increases the Risk for Rotator Cuff Tears

  • Keith M. BaumgartenEmail author
  • David Gerlach
  • Leesa M. Galatz
  • Sharlene A. Teefey
  • William D. Middleton
  • Konstantinos Ditsios
  • Ken Yamaguchi
Original Article


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.


Rotator Cuff Shoulder Pain Rotator Cuff Tear Rotator Cuff Repair Tobacco Exposure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We thank Stephen Mandel and Hyun Min Kim in the Washington University School of Medicine Department of Biostatistics for providing statistical consultation for this manuscript.


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Copyright information

© The Association of Bone and Joint Surgeons 2009

Authors and Affiliations

  • Keith M. Baumgarten
    • 1
    Email author
  • David Gerlach
    • 2
  • Leesa M. Galatz
    • 2
  • Sharlene A. Teefey
    • 3
  • William D. Middleton
    • 3
  • Konstantinos Ditsios
    • 3
  • Ken Yamaguchi
    • 2
  1. 1.Orthopedic InstituteSioux FallsUSA
  2. 2.Department of Orthopaedic SurgeryWashington University School of MedicineSt LouisUSA
  3. 3.Department of Diagnostic RadiologyWashington University School of Medicine, MIR Institute of RadiologySt LouisUSA

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