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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 8, 1027-1031.
doi: 10.1302/0301-620X.88B8.17189  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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Smoking and reconstruction of the anterior cruciate ligament

A. Karim, MRCS, Specialist Registrar in Trauma & Orthopaedic Surgery1; H. Pandit, FRCS(Orth), Clinical Fellow in Trauma & Orthopaedic Surgery1; J. Murray, MA, FRCS(Orth), Specialist Registrar in Trauma & Orthopaedic Surgery1; F. Wandless, BSc, Senior Physiotherapist1; and N. P. Thomas, BSc, FRCS, Consultant Orthopaedic Surgeon1

1 North Hampshire Hospital, Aldermaston Road, Basingstoke RG24 9NA, UK.

Correspondence should be sent to Mr A. Karim at 17 Rampart Walk, Dorchester, Dorset DT1 2QZ, UK; e-mail: mail{at}amerkarim.com

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.




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Does smoking influence outcome after autologous chondrocyte implantation?: A CASE-CONTROLLED STUDY
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[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General