Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 12,
1575-1578.
doi: 10.1302/0301-620X.91B12.22879
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
Does smoking influence outcome after autologous chondrocyte implantation?
A CASE-CONTROLLED STUDY
P. K. Jaiswal, MRCS, Academic Clinical Fellow1;
S. Macmull, MRCS, Clinical Research Fellow1;
G. Bentley, ChM, FRCS, Professor of Orthopaedics1;
R. W. J. Carrington, FRCS(Orth), Consultant Orthopaedic Surgeon1;
J. A. Skinner, FRCS(Orth), Consultant Orthopaedic Surgeon1; and
T. W. R. Briggs, FRCS, Consultant Orthopaedic Surgeon1
1 Institute of Orthopaedics Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK.
Correspondence should be sent to Mr P. K. Jaiswal; e-mail: pkjresearch{at}googlemail.com
Smoking is known to have an adverse effect on wound healing and musculoskeletal conditions. This case-controlled study looked at whether smoking has a deleterious effect in the outcome of autologous chondrocyte implantation for the treatment of full thickness chondral defects of the knee.
The mean Modified Cincinatti Knee score was statistically significantly lower in smokers (n = 48) than in non-smokers (n = 66) both before and after surgery (p < 0.05). Smokers experienced significantly less improvement in the knee score two years after surgery (p < 0.05). Graft failures were only seen in smokers (p = 0.016). There was a strong negative correlation between the number of cigarettes smoked and the outcome following surgery (Pearsons correlation coefficient –0.65, p = 0.004).
These results suggest that patients who smoke have worse pre-operative function and obtain less benefit from this procedure than non-smokers. The counselling of patients undergoing autologous chondrocyte implantation should include smoking, not only as a general cardiopulmonary risk but also because poorer results can be expected in smokers following this procedure.