title: The impact of preoperative smoking habit on rotator cuff tear: cigarette smoking influences rotator cuff tear sizes.
abstract: OBJECTIVE
  Smoking is an important risk factor for the development of rotator cuff tears. We hypothesized that smoking may also influence rotator cuff tear size.
  
  
  METHODS
  The study included 408 patients who underwent arthroscopic repair of cuff tear. Cuff tears were classified during surgery. We analyzed the percentage of smokers and the association of the amount and duration of smoking exposure with the type of tear. The average number of daily cigarettes and the total number of cigarettes in life were studied using age and gender as covariates.
  
  
  RESULTS
  Smokers comprised 131 of 408 patients (32.1%). A type I tear affected 95 patients (23.3%), type II affected 214 (52.5%), type III affected 74 (18.1%), and type IV affected 25 (6.1%). Smokers comprised 23.2% (22 patients) of patients with type I tear, 33.6% (72 patients) of patients with type II tears, 36.5% (27 patients) of patients with type III tears and 40% (10 patients) of patients with IV tears. The frequency of smokers with at least a type II tear was 34.8% and differed significantly from the 23.2% of the type I tear patients (P = 0.033). Total number of cigarettes was significantly higher in patients with an at least a type II tear (F(1,127) = 4.694, P = .032).
  
  
  CONCLUSIONS
  Rotator cuff has a relatively hypovascular insertion into the greater tuberosity. Cigarette smoking negatively affects vascularity of tendons.
  
  
  CONCLUSIONS
  There is a correlation between cigarette smoking habit, rotator cuff tear, and tear size. There was an increasing daily average number of cigarettes and a total number of cigarettes smoked in life across patients with increasing severity of tears.
authors.affiliation: Department of Orthopaedic and Traumatology, University of Rome Sapienza, Rome, Italy. stefcarbone@yahoo.it
authors.forename: Stefano
authors.initials: S
authors.lastname: Carbone
authors.forename: Stefano
authors.initials: S
authors.lastname: Gumina
authors.forename: Valerio
authors.initials: V
authors.lastname: Arceri
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Campagna
authors.forename: Corrado
authors.initials: C
authors.lastname: Fagnani
authors.forename: Franco
authors.initials: F
authors.lastname: Postacchini
mesh_terms: D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D017006:Rotator Cuff / Q000601:surgery; D000070636:Rotator Cuff Injuries; D012421:Rupture; D012785:Shoulder Joint; D012907:Smoking / Q000009:adverse effects*; D013708:Tendon Injuries / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D013997:Time Factors