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Impact of Smoking on Clinical Outcomes of Open Arthrolysis for Post-Traumatic Elbow Stiffness

Ziyang Sun, Cunyi Fan and Hao Xiong

Background: Elbow stiffness is a common orthopedics problem after elbow trauma. Meanwhile, smoking is becoming a worldwide public health challenge, which has been considered as a predisposing factor for adverse functional outcomes after various orthopedic surgeries. This retrospective study seeks to identify whether smoking affects clinical outcomes of open arthrolysis for post-traumatic elbow stiffness in male patients.

Methods: A total of 95 male patients referred to our institution received open arthrolysis for post-traumatic elbow stiffness from January 2015 to August 2016 were divided into 2 groups: currently smoking group (n=36) and currently non-smoking group (n=59). General patients’ data and elbow functions like range of motion (ROM), forearm rotational arc, Mayo Elbow Performance Sore (MEPS), Visual Analogue Score (VAS), ulnar nerve symptoms and muscle strength were documented.

Results: Significant differences were found in ROM (P=0.017), MEPS (P=0.004) and VAS (P=0.035) between the 2 groups, and currently smoking group had the poorer clinical outcomes. However, no differences were found in forearm rotational arc (P=0.057) and complications such as ulnar nerve symptoms (P=0.431), reduced muscle strength (P=0.948) and elbow instability (P=0.369).

Conclusions: Patients who smoke are at increased risk of poorer outcomes after open artholysis for posttraumatic elbow stiffness. Therefore, attention and interference may be instructed to patients who smoke after open arthrolysis in daily clinical work, such as smoking cessation.

Level of evidence: Level III; Retrospective Cohort Design; Treatment Study