Jaiswal P K, Macmull S, Bentley G, Carrington R W J, Skinner J A, Briggs T W R
Institute of Orthopaedics, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, UK.
J Bone Joint Surg Br. 2009 Dec;91(12):1575-8. doi: 10.1302/0301-620X.91B12.22879.
Smoking is known to have an adverse effect on wound healing and musculoskeletal conditions. This case-controlled study looked at whether smoking has a deleterious effect in the outcome of autologous chondrocyte implantation for the treatment of full thickness chondral defects of the knee. The mean Modified Cincinatti Knee score was statistically significantly lower in smokers (n = 48) than in non-smokers (n = 66) both before and after surgery (p < 0.05). Smokers experienced significantly less improvement in the knee score two years after surgery (p < 0.05). Graft failures were only seen in smokers (p = 0.016). There was a strong negative correlation between the number of cigarettes smoked and the outcome following surgery (Pearson's correlation coefficient -0.65, p = 0.004). These results suggest that patients who smoke have worse pre-operative function and obtain less benefit from this procedure than non-smokers. The counselling of patients undergoing autologous chondrocyte implantation should include smoking, not only as a general cardiopulmonary risk but also because poorer results can be expected in smokers following this procedure.
众所周知，吸烟会对伤口愈合和肌肉骨骼疾病产生不利影响。这项病例对照研究探讨了吸烟是否会对自体软骨细胞植入治疗膝关节全层软骨缺损的疗效产生有害影响。在手术前后，吸烟者（n = 48）的改良辛辛那提膝关节评分均值在统计学上显著低于非吸烟者（n = 66）（p < 0.05）。吸烟者在术后两年膝关节评分的改善明显较少（p < 0.05）。移植失败仅见于吸烟者（p = 0.016）。吸烟数量与术后结果之间存在很强的负相关性（皮尔逊相关系数 -0.65，p = 0.004）。这些结果表明，吸烟患者术前功能较差，与非吸烟者相比，从该手术中获得的益处更少。对接受自体软骨细胞植入的患者进行咨询时应包括吸烟问题，这不仅是因为吸烟对心肺有一般风险，还因为预计吸烟者接受该手术后效果会更差。
