Smokers have worse outcomes after knee surgery than non-smokers, including less-complete healing and more surgical complications, according to a new analysis.
Smoking has a profound effect on circulation, so that means it even affects musculoskeletal healing.
Surgeons had a hunch smoking was related to worse outcomes after knee surgery.
They gathered the results of 14 studies, eight of which looked at surgical repair of knee ligaments, including the anterior cruciate ligament (ACL), and six of which examined repair of knee cartilage.
For instance, smokers were less likely to return to their pre-injury level of sport and experienced more pain. One study from the University of Pittsburgh School of Medicine found surgery patients who smoked were 64 percent less likely to report a successful outcome than non-smokers.
The one study that did not find any difference between smokers and non-smokers examined patients' risk of developing osteoarthritis in the knee.
Four studies on cartilage surgery found that smokers were less likely to have excellent results after surgery, had less improvement in the knee years later or had fewer beneficial proteins in the knee fluid than non-smokers.