The rate of smoking in patients who have suffered from ACLR graft rupture

IF 2 Q2 ORTHOPEDICS

Journal of Experimental Orthopaedics Pub Date : 2025-04-24 DOI:10.1002/jeo2.70237

W. P. Yau

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引用次数: 0

Abstract

Purpose

The purpose of this study was to investigate the rate of smoking in patients who suffered from anterior cruciate ligament reconstruction (ACLR) graft rupture. It was hypothesised that there would be no difference in the ACLR graft rupture rates between smokers and non-smokers.

Methods

A retrospective study was conducted on patients who underwent primary ACLR using hamstring autograft at the author's institute between 2007 and 2021. Patients with unknown smoking status were excluded. All included patients received post-operative magnetic resonance imaging for assessment of graft integrity. The rate of graft rupture was reported. A case–control study was performed to determine the relationship between smoking and ACLR graft rupture by matching age, sex, chronicity of tear, diameter and type of ACLR graft, Grade 3 pivot-shift, type of ACLR and concomitant anterolateral ligament reconstruction between smokers and non-smokers.

Results

A total of 495 primary ACLRs were included. The patients were aged 27.2 ± 8.2 years. There were 397 men and 98 women, with a smoking rate of 20%. The average follow-up was 78 ± 48 months. 16.2% of smokers, compared to 10.1% of non-smokers, suffered from graft rupture. The median yearly rate of graft rupture was 2 per 100 ACLRs (interquartile range [IQR] = 2.4) for smokers, compared to 1 per 100 ACLRs (IQR = 0.6) for non-smokers. One hundred seventy-two patients were matched. Smokers were found to have a higher risk of suffering from graft rupture compared to non-smokers in the case–control matching analysis (odds ratio = 2.6, 95% confidence interval = 1.01–6.63).

Conclusion

In a cohort of 495 primary ACLRs operated using hamstring autograft with a 20% smoking rate, the rates of ACLR graft rupture and revision ACLR at a mean follow-up of 6.5 ± 4 years were 11.3% and 8.3%, respectively. Smoking was associated with an increased risk of graft rupture in a case–control matching subgroup analysis.

Level of Evidence

Level IV.

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ACLR移植破裂患者的吸烟率

目的探讨前交叉韧带重建（ACLR）移植破裂患者的吸烟率。假设吸烟者和非吸烟者之间ACLR移植物破裂率没有差异。方法回顾性研究2007年至2021年在作者所在研究所接受自体腘绳肌腱移植术的原发性ACLR患者。排除吸烟状况不详的患者。所有患者均接受术后磁共振成像以评估移植物的完整性。报道了接枝破裂率。通过配对吸烟者和非吸烟者之间的年龄、性别、撕裂的慢性程度、ACLR移植物直径和类型、3级枢轴移位、ACLR类型和伴随的前外侧韧带重建，进行病例对照研究，以确定吸烟与ACLR移植物破裂之间的关系。结果共纳入495例原发性ACLRs。患者年龄27.2±8.2岁。男性397人，女性98人，吸烟率为20%。平均随访78±48个月。16.2%的吸烟者和10.1%的非吸烟者遭受移植物破裂。吸烟者移植血管破裂的中位年发生率为2 / 100 ACLRs（四分位间距[IQR] = 2.4），而非吸烟者为1 / 100 ACLRs （IQR = 0.6）。172名患者被匹配。在病例对照匹配分析中，吸烟者比非吸烟者有更高的移植物破裂风险（优势比= 2.6,95%可信区间= 1.01-6.63）。结论在495例原发性ACLR患者中，采用腘绳肌腱自体移植手术，吸烟率为20%，平均随访6.5±4年，ACLR移植破裂率和ACLR翻修率分别为11.3%和8.3%。在病例对照匹配亚组分析中，吸烟与移植物破裂风险增加有关。证据等级四级。

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