Avaliação do efeito da obesidade e do tabagismo no resultado cirúrgico de lesão do manguito rotador em população de baixa renda

• Ano de defesa: 2020
• Autor(a) principal: Silva, Christine Maria Muniz
• Orientador(a): Leite, José Alberto Dias
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Palavras-chave em Português: Lesões do Manguito Rotador; Síndrome Metabólica; Obesidade; Tabagismo
• Link de acesso: http://www.repositorio.ufc.br/handle/riufc/56336

Rotator cuff tears (RCT) rank first among causes of shoulder pain in primary care. Surgical repair is the choice treatment when refractory to clinical treatment. Comorbidities and environmental issues can impact RCT repair results. We therefore try to determine if obesity and smoking can deteriorate surgical outcomes in a low-income (<5500,00 US$ annual pib per capta*) population submitted to RCT repair. This was a cross-sectional study of 42 patients (47 shoulders) subjected to surgical repair of rotator cuff tear either arthroscopic or open, minimun 2-years follow-up. The protocol was approved by the local Ethical Committee (number: CAEE 97223018.0.0000.5040). Patients were clinically evaluated, with demographic data registered focusing on Obesity (BMI >/≤ 30) and Smoking status (present/absent). For physical evaluation were recorded: pain, active forward elevation (FE), active external rotation (ER), functional shoulder scores (ASES and UCLA) The data were analysed with T Student test. The patients were 59.98±7.4 years-old, 35(74.4%) female; 17 (36,1%) smokers, and 13 (27,6%) Obese (BMI >30). Other comorbidities included 21 arterial hypertension, 20 dyslipidemia, 21 diabetes mellitus, 17 knee osteoarthritis, and 12 hand osteoarthritis. UCLA values were 24.2 vs 27.3 (p=0.059); ASES 52.9 vs. 65.6 (p=0,08); VAS 5.3 vs. 3.7 (p=0,043); ER 41.5º vs. 49.57º (p=0,029); FF 133.3 º vs. 137.5º (p=0,364) in Smokers vs. Non-smokers, respectively. UCLA values were 25.3 vs 27.2 (p=0,076); ASES 57.5 vs. 62.2 (p=0,322); VAS 4.8 vs. 4.0 (p=0,196); ER 43.05º vs. 48.7º (p=0,124), and FF 133.12º vs. 137.36º (p=0,365) in Obese vs Non-Obese, respectively. Using patient reported outcome instruments, these midterm data show that Smoking can negatively impacts the outcome of surgical repair of RCT in low-income patients. Education on cessation of smoking is a practical, affordable, though hard to implement, measure that could improve RC surgical results.