The impact of preoperative opioid use on outcomes after arthroscopic rotator cuff repair

BACKGROUND: Preoperative opioid use has been correlated to suboptimal outcomes in orthopedic surgery. This study evaluated the effect of preoperative opioid use on outcomes after arthroscopic rotator cuff repair (RCR). METHODS: A retrospective review was performed of 79 patients who underwent arthroscopic RCR; of these, 31 with a history of preoperative opioid use were compared with a control group of 48 patients without a history of preoperative opioid use. Preoperative and postoperative patient-reported outcomes and functional scores were compared. RESULTS: Both cohorts significantly improved on all patient-reported shoulder scores; however, the nonopioid group demonstrated significantly better postoperative patient-reported outcome scores (P = .015) and external rotation measurement (P = .008). Functional outcomes also significantly improved from preoperatively to postoperatively for forward flexion, but no differences were seen between groups. CONCLUSIONS: Patients with a history of preoperative opioid use can still achieve significant improvements in outcomes after arthroscopic RCR, although not to the same extent as opioid-naïve patients. Therefore, orthopedic surgeons must consider a patient's preoperative opioid use and temper expectations with regard to outcomes so that they are able to set realistic postoperative goals for patients undergoing RCR.