Long-term nonsteroidal anti-inflammatory drug use is associated with rotator cuff tears in adult patients

Abstract

Background

To determine if long-term nonsteroidal anti-inflammatory drug (NSAID) is associated with rotator cuff tears (RCTs) in an adult population.

Methods

A retrospective study using a national database was performed. All patients with a diagnosis of long-term NSAID use with active records for at least 1 year or 2 years were identified. These patients were matched 1:1 to controls without NSAID use based on age, gender, and Charlson comorbidity index. Rates of new rotator cuff tendon tears were compared. Subgroup analyses in the following age ranges for each sex were done: 35-45, 46-55, 56-65, and 66-75.

Results

Out of 499,240 patients with chronic NSAID use, 10,180 patients sustained a RCT compared to 7471 of the control patients (2.04% vs. 1.50%, respectively; odds ratio [OR]: 1.18; 95% confidence interval [CI]: 1.14-1.21; P < .001). Male NSAID users in the 46-55 age range had higher rates of RCTs compared to matched control patients (OR: 1.41; 95% CI: 1.30-1.52; P < .001). Female NSAID users in the 46 to 55 age range had higher rates of RCTs compared to matched control patients (OR: 1.40; 95% CI: 1.31-1.49; P < .001). Comparable results were seen in the 56-65 age range for both males and females. Furthermore, chronic NSAID users (n = 1888; 18.5%) underwent rotator cuff repair at higher rates compared to controls (n = 1223; 16.4%; P = .01).

Conclusion

Long-term NSAID use is associated with an increased incidence of rotator cuff tendon tears at the 1- and 2-year follow-up periods in adult patients, particularly those in the 46-55 age range.