Effect of Cigarette Smoking on Midterm Outcomes After Arthroscopic Surgery for Femoroacetabular Impingement Syndrome: A Propensity-Matched Controlled Study With Minimum 5-Year Follow-up.

BACKGROUND

There is limited literature evaluating patient-reported outcomes (PROs) in cigarette smokers undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS) at midterm follow-up.

PURPOSE

(1) To report minimum 5-year PROs for cigarette-smoking patients who underwent primary hip arthroscopy for FAIS and (2) to compare these results with a propensity-matched control group of never-smoking patients.

STUDY DESIGN

Cohort study; Level of evidence, 3.

METHODS

Data were collected for all patients who underwent primary hip arthroscopy for FAIS between June 2009 and March 2016. Patients were eligible if they indicated that they smoked cigarettes within 1 month of surgery and had minimum 5-year postoperative outcomes for the modified Harris Hip Score, Nonarthritic Hip Score, Hip Outcome Score-Sport Specific Subscale (HOS-SSS), and International Hip Outcome Tool-12 (iHOT-12). The percentages of patients achieving the Patient Acceptable Symptom State (PASS) and maximum outcome improvement satisfaction threshold were recorded. The study group was then propensity matched in a 1:2 ratio to patients who had never smoked for comparison.

RESULTS

Included were 35 patients (35 hips) with a mean age of 39.4 ± 13.0 years and mean follow-up of 64.6 ± 4.1 months. These patients demonstrated significant improvement from preoperatively to a minimum 5-year follow-up for all recorded PROs ( < .05). When compared with 70 control patients (70 hips), smoking patients demonstrated significantly worse preoperative scores for all PROs ( < .05). Study patients also demonstrated worse minimum 5-year scores for all recorded PROs compared with control patients, which did not reach statistical significance but trended toward significance for HOS-SSS (70.4 vs 81.9; = .076) and iHOT-12 (74.7 vs 82.2; = .122). Smoking patients also trended toward lower rates of achieving PASS for the iHOT-12 compared with never-smoking patients (50.0% vs 68.2%; = .120).

CONCLUSION

Patients who smoked cigarettes and underwent primary hip arthroscopy for FAIS demonstrated significant improvement in PROs at a minimum 5-year follow-up. When compared with a propensity-matched control group of never-smokers, they trended toward lower postoperative HOS-SSS and iHOT-12 scores and lower rates of achieving PASS on the iHOT-12.