Effect of Cigarette Smoking on Midterm Outcomes After Arthroscopic Surgery for Femoroacetabular Impingement Syndrome: A Propensity-Matched Controlled Study With Minimum 5-Year Follow-up
Authors: Jimenez AE, Lee MS, Owens JS, Maldonado DR, Saks BR, Lall AC, Domb BG
Journal: Orthopaedic Journal of Sports Medicine, May 2022
DOI: 10.1177/23259671221090905
Background
The long-term effects of smoking on hip arthroscopy outcomes remain underexplored. This study compares the 5-year postoperative outcomes of patients who smoked within one month of surgery versus matched never-smokers.
Methods
- Retrospective review of patients undergoing hip arthroscopy for FAIS between 2009 and 2016.
- Smokers (n = 46) were propensity matched to nonsmokers based on demographics and baseline pathology.
- Outcomes included mHHS, NAHS, HOS-SSS, iHOT-12, and rates of achieving PASS.
Key Findings
- Both smokers and nonsmokers demonstrated significant postoperative improvement.
- Smokers had lower preoperative scores and trended toward lower 5-year PROs, particularly in HOS-SSS and iHOT-12 (p = .076 and .122, respectively).
- Smokers also showed reduced PASS achievement rates.
Conclusions
While smokers benefit from hip arthroscopy, their long-term outcomes may be inferior to those of nonsmokers. Smoking remains a risk factor for suboptimal recovery.
What Does This Mean for Providers?
Patients who smoke may still achieve improvement from hip arthroscopy, but providers should clearly communicate that long-term outcomes are less favorable compared to nonsmokers. Preoperative smoking cessation counseling is warranted to optimize recovery potential.