No Effect of Cigarette Smoking in the Outcome of Arthroscopic Management for Femoroacetabular Impingement: A Systematic Review

Background: The impact of smoking in arthroscopic surgery for femoroacetabolar impingement (FAI) is controversial. This systematic review updates and discusses current evidence on the influence of cigarette smoking on the outcome of arthroscopic management of FAI. The outcomes of interest were to compare patient-reported outcome measures (PROMs) and complications. Methods: The present systematic review followed the PRISMA guidelines. Embase, Web of Science, and PubMed were accessed in June 2024 without additional filters or temporal constraints. All the clinical investigations comparing smokers versus nonsmokers in patients who underwent arthroscopic management for FAI were considered. The risk of bias in nonrandomised controlled trials was assessed using the Risk of Bias in Nonrandomised Studies of Interventions (ROBINS-I). Results: Data from 368 patients were retrieved. The mean length of follow-up was 34.1 +/- 7.1 months. The mean age was 40.4 +/- 4.0 years and the mean BMI was 27.1 +/- 1.6 kg/m2. No significant difference was evidenced in the visual analogue scale, Harris hip score, Hip Outcome Score-Sport subscale, and Non-Arthritic Hip Score. No difference was observed in the complication rate: reoperation (p = 0.6) and progression to THA (p = 0.4). Conclusions: Tobacco smoking does not appear to influence the outcomes of arthroscopic management for FAI. At approximately 34 months of follow-up, no difference was found in pain, PROMs, reoperation rate, and progression to THA.