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We sought to determine whether smoking affected the outcome of reconstruction of the anterior cruciate ligament. We analysed the results of 66 smokers (group 1 with a mean follow-up of 5.67 years (1.1 to 12.7)) and 238 non-smokers (group 2 with a mean follow-up of 6.61 years (1.2 to 11.5)), who were statistically similar in age, gender, graft type, fixation and associated meniscal and chondral pathology. The assessment was performed using the International Knee Documentation Committee form and serial cruciometer readings. Poor outcomes were reported in group 1 for the mean subjective International Knee Documentation Committee score (p < 0.001), the frequency (p = 0.005) and intensity (p = 0.005) of pain, a side-to-side difference in knee laxity (p = 0.001) and the use of a four-strand hamstring graft (p = 0.015). Patients in group 1 were also less likely to return to their original level of pre-injury sport (p = 0.003) and had an overall worse final 7 International Knee Documentation Committee grade score (p = 0.007). Despite the well-known negative effects of smoking on tissue healing, the association with an inferior outcome after reconstruction of the anterior cruciate ligament has not previously been described and should be included in the pre-operative counselling of patients undergoing the procedure.

Original publication

DOI

10.1302/0301-620x.88b8.17189

Type

Journal article

Journal

The Journal of bone and joint surgery. British volume

Publication Date

08/2006

Volume

88

Pages

1027 - 1031

Addresses

North Hampshire Hospital, Aldermaston Road, Basingstoke RG24 9NA, UK. mail@amerkarim.com

Keywords

Leg, Anterior Cruciate Ligament, Muscle, Skeletal, Knee Joint, Humans, Joint Instability, Knee Injuries, Pain Measurement, Treatment Outcome, Exercise, Cohort Studies, Smoking, Wound Healing, Adolescent, Adult, Middle Aged, Female, Male