The association between smoking behaviour and severity of rotator cuff tear of the shoulder.

Introduction. Smoking is an important risk factor for the development of rotator cuff tears. We hypothesized smoking may influence rotator cuff tear size. Material and methods.408 patients who underwent arthroscopic cuff tear repair were included in the study group (Cuff tears classified intraoperatively with SCOl Classification). We analysed the frequencies of smokers and the association of the amount and duration of smoke exposure with the type of tear. The average number of cigarettes per day and the total number of cigarettes in life were studied using age and gender as covariates. Results 131 patients were smokers (32.1%), 277 (67.9%) were non smokers. There were 95 patients affected by type I tear (23.3%), 214 by type II (52.5%), 74 by type III tear (18.1%) and 25 by type IV tear (6.1%). The frequency of smokers was 23.2% (22 patients) among the type 1 tear patients, 33.6% (72 patients) among the type II tear, and 36.5% (27 patients) and 40% (10 patients) among the type III and IV tears, respectively. The frequency of smokers with an at least type II tear resulted 34.8% and differed significantly from the 23.2% of the type I tear patients (p = 0.033). Total number of cigarettes resulted significantly higher in patients with an at least type 11 tear (F( 1.127) = 4.694, p = 0.032). Conclusions Cigarette smoking has a correlation with sizes of rotator cuff tear. There is an increasing daily average numbers of cigarettes and a total number of cigarettes smoked in life across patients with increasing severity of tears.