Association of alcohol consumption and rotator cuff retear: a case control matched cohort study.

BACKGROUND

Failure of healing or retear after surgical repair of the rotator cuff tendons are still a problem and can cause ongoing shoulder pain and dysfunction. Compromised microcirculation as seen in regular alcohol consumption may lead to poor healing.

PURPOSE: To compare the clinical outcomes and tendon integrity of patients after rotator cuff repair with and without regular alcohol intake.

STUDY

DESIGN

Case control matched cohort study; Level of evidence, 3.

METHODS

Patients who underwent arthroscopic rotator cuff repair (ARCR), had regular alcohol intake (according to world health organization (WHO) definition of harmful alcohol consumption) and were at least 2 years postoperative were included, and matched according to age, sex, involved tendon, and tear size with patients who underwent ARCR without regular alcohol intake. Patient-reported outcome (PRO) scores were collected at final follow-up including the Constant Murley Score (CMS), Western Ontario Rotator Cuff Score (WORC), Simple Shoulder Test (SST), and visual analog scale (VAS). Tendon integrity (maintained continuity: yes/no = full thickness) was assessed by ultrasound examination at final follow-up. Complications and revision surgeries are reported.

RESULTS

Twenty-two patients (versus twenty-two matched-controls) were available for follow-up. There were two female (9%) and twenty male (91%) patients with a mean age of 66.6 years (standard deviation, 36-85 years). The mean follow-up was 4 years (standard deviation, 2-5 years) in the alcohol group and 5 years (standard deviation, 2-10 years) in the non-alcohol group. No differences in mean PRO scores between alcohol and non-alcohol groups were seen except VAS (0.5 (standard deviation, 0-5) vs. 1.6 (standard deviation, 0-8), (P = 0.049*) respectively). Intact tendon insertion was seen in 77% (17/22) for the alcohol group and 100% (22/22) for non-alcohol group, (P = 0.021*). One patient underwent revision surgery (5%) in the alcohol group due to a retear, no further peri- or postoperative complications were noticed.

CONCLUSION

Patients with torn rotator cuff tendons benefited similarly from ARCR independently of their alcohol use concerning clinical presentation. However, significantly higher retear rates were recorded in the alcohol group.