Tobacco use is associated with increased rates of infection and revision surgery after primary superior labrum anterior and posterior repair

J Shoulder Elbow Surg. 2016 Nov;25(11):1764-1768. doi: 10.1016/j.jse.2016.03.009. Epub 2016 Jun 1.


Background: Although the general health consequences of tobacco use have been well defined, the effects of perioperative tobacco use on arthroscopic shoulder procedures remain largely unknown. The purpose of this study is to use a national database to investigate the relationship between tobacco use and rates of superior labrum anterior and posterior (SLAP) repair failure and postoperative infection after primary SLAP repair compared with matched controls.

Methods: A national private-payer insurance database was queried for patients who underwent arthroscopic primary SLAP from 2005-2012. These patients were divided into tobacco use and non-tobacco use cohorts using International Classification of Diseases, Ninth Revision coding. The non-tobacco use patients were then matched to the patients with coded tobacco use. Both cohorts were assessed for postoperative infection within 90 days and subsequent ipsilateral revision SLAP repair or biceps tenodesis within up to 7 years postoperatively.

Results: The incidences of revision SLAP repair or revision to a biceps tenodesis (P = .023) and postoperative infection (P = .034) were significantly higher in patients who used tobacco versus matched controls.

Conclusions: SLAP repair in patients who use tobacco is associated with significantly increased rates of postoperative infection and revision SLAP repair or conversion to a biceps tenodesis.

Keywords: SLAP repair; biceps tenodesis; complications; infection; revision surgery; tobacco.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Databases, Factual
  • Female
  • Humans
  • Male
  • Middle Aged
  • Reoperation / statistics & numerical data*
  • Shoulder Injuries / surgery*
  • Smoking / adverse effects*
  • Smoking / epidemiology
  • Surgical Wound Infection / epidemiology*
  • Tenodesis / statistics & numerical data
  • United States / epidemiology
  • Young Adult