The effect of smoking on ligament and cartilage surgery in the knee: a systematic review

Kanneganti P, Harris JD, Brophy RH, et al. · The American Journal of Sports Medicine

Seven of the eight ligament studies, basic-science and clinical, found smoking harmful; the exception was a radiographic knee-OA count 8 years after ACL reconstruction (p = 0.18). Of the six cartilage studies, one lavage-fluid study and three clinical series found smokers doing worse — in the autologous chondrocyte implantation series every graft failure was a smoker — while a microfracture and a mosaicplasty series found no smoking effect; the authors call the cartilage picture less clear but still pointing to an overall negative influence. No study of smoking and meniscal surgery existed.

Population

14 studies (8 ligament, 6 cartilage) of smokers undergoing knee ligament or cartilage surgery

Intervention

Smoking (observed)

Comparator

Non-smokers

Limitations

Included studies observational and heterogeneous, all from four high-income countries and all small; cartilage subset six studies with two nulls; publication bias possible. The authors declare no conflicts; no funding statement.