Effect of Cigarette Smoking on Outcomes in Patients Undergoing Primary Hip Arthroscopy and Labral Reconstruction: A Propensity-Matched Controlled Study With Minimum 2-Year Follow-up
Authors: Jimenez AE, Lee MS, George T, Owens JS, Maldonado DR, Saks BR, Lall AC, Domb BG
Journal: Orthopaedic Journal of Sports Medicine, February 2022
DOI: 10.1177/23259671221075642
Background
Smoking is a known risk factor for impaired wound healing and poor surgical outcomes, but its impact on hip arthroscopy with labral reconstruction has not been well established.
Methods
- A propensity-matched cohort study of smokers vs. non-smokers undergoing primary hip arthroscopy with labral reconstruction.
- Patient-reported outcomes (mHHS, NAHS, VAS) and revision surgery rates were evaluated at a minimum of 2 years postoperatively.
Key Findings
- Smokers achieved significant improvement in PROs postoperatively.
- However, smokers had lower PASS rates (55% vs. 75%), lower NAHS MCID achievement (40% vs. 61.7%), and a higher secondary surgery rate (25% vs. 5%).
- Survivorship at follow-up was markedly lower for smokers (80% vs. 98.3%).
Conclusions
While smokers benefit from labral reconstruction, their functional outcomes and surgical survivorship are inferior compared to non-smokers.
What Does This Mean for Providers?
Preoperative counseling should include a clear discussion on the adverse impact of smoking on hip arthroscopy outcomes, including lower likelihood of achieving functional benchmarks and higher revision rates. Smoking cessation should be strongly recommended pre- and post-operatively to improve surgical success.