SynthesisEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2024
Examining the role of smoking on clinical outcomes after arthroscopic surgery of the hip: a systematic review and meta-analysis.
Synthesis in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThis study evaluates the impact of smoking on clinical outcomes following hip arthroscopy (HA) through a systematic review and meta-analysis.
methodsThis systematic review and meta-analysis queried PubMed, Scopus, Cochrane, and CINAHL from inception to April 30, 2024, for articles related to smoking and HA outcomes. A random-effects model meta-analysis using relative risk (RR) and 95% confidence intervals was performed to compare smokers and nonsmokers for conversion to total hip arthroplasty (THA) and revision hip arthroscopy (RHA).
resultsTwenty observational studies (n = 115,203 patients; 66.95% female; mean age: 36.93 ± 6.53 years; mean follow-up: 22.10 ± 7.56 months) were included. Nine studies investigated smoking and conversion to THA, six examined smoking and RHA, eight assessed smoking and postoperative patient-reported outcomes, and eight evaluated smoking and postoperative complications. Regarding conversion to THA, 5 studies (55.56%) found a significant association, while 4 (44.44%) did not. Meta-analysis from four studies found no significant association between smoking and THA conversion (p = 0.48, OR: 1.02; 95% CI: [0.98-1.06]) or smoking and RHA (p = 0.305, OR: 1.00; 95% CI: [0.97-1.03]). Only 2 studies (33.33%) found a significant association between smoking and RHA, whereas four did not. Six studies found smoking significantly implicated in complications such as HA failure, increased opioid use, infection risk, and venous thromboembolism (VTE). THA conversion rates were 6.54% (n = 14/214) among smokers versus 3.57% (n = 13/364) among nonsmokers.
conclusionThis study found no statistically significant association between smoking and THA conversion, though smokers were observed to experience higher conversion rates overall. Similarly, no significant association was observed for smoking and RHA at 2-year follow-up. However, trends suggest that smokers experience greater risks of adverse outcomes, particularly VTE and HA failure, which should be considered in clinical decision-making. LEVEL OF EVIDENCE: Level III.
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