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Smoking Has Negative Impact on Success of ACL Reconstruction
Negative effect on subjective and objective outcomes of anterior cruciate ligament reconstruction

THURSDAY, July 10, 2014 (HealthDay News) -- Cigarette smoking is associated with a negative impact on anterior cruciate ligament (ACL) reconstruction outcomes, according to a study published in the June 18 issue of The Journal of Bone & Joint Surgery.

Sung-Jae Kim, M.D., Ph.D., from the Yonsei University College of Medicine in South Korea, and colleagues conducted a retrospective review of 251 patients who underwent unilateral ACL reconstruction with use of bone-patellar tendon-bone autograft from January 2002 to August 2009. Preoperative values and 24-month postoperative findings were compared for nonsmokers, current smokers, and former smokers.

The researchers found that the three groups differed significantly in terms of postoperative mean side-to-side anterior knee translation (P = 0.003), mean Lysholm score (P < 0.001), and mean International Knee Documentation Committee (IKDC) subjective score (P < 0.001); there was no minimal clinically important difference seen in the difference in IKDC subjective score. Pack-years of exposure correlated with postoperative anterior translation (P = 0.015) and IKDC objective grade (odds ratio, 1.083; P = 0.002) in a dose-dependent manner. There was a significant difference for light, moderate, and heavy smokers in anterior translation (P = 0.038) and in the proportion of cases by IKDC objective grade (P = 0.013).

"Cigarette smoking appeared to have a negative effect on subjective and objective outcomes of ACL reconstruction, and heavy smokers showed greater knee instability," the authors write.

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October 20, 2014

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