Risk of ACL and Meniscus Injury, and Subsequent Surgical Repair Increased in Tobacco Users: A Case-Controlled Retrospective Cohort Study of over 3 Million Patients

Objective: The purpose of this study was to determine if individuals who use tobacco are at increased odds of: (1) Meniscus or ACL injury; (2) meniscus or ACL reconstructive surgery; and (3) in-hospital lengths of stay (LOS). Background: While literature demonstrates associations between tobacco use and ligament reconstruction complications, there is little data analyzing risks that tobacco use may have on the injury development, need for subsequent surgery, or impact on lengths of stay (LOS). Methods: An insurance claims population was retrospectively analyzed using ICD-9 and ICD-10 codes. Patients who used tobacco were matched to controls according to age and medical comorbidities. Outcomes analyzed included: meniscus or ACL injury; (2) meniscus or ACL reconstructive surgery; and (3) in-hospital LOS. A p-value less than 0.05 was considered statistically significant. Results: Tobacco users had increased odds (3.43 vs. 3.28%; OR: 1.10, pppp Conclusion: This analysis of over 3 million patients demonstrates that tobacco use increases incidence and odds of both meniscus and ACL injury, surgical repair and LOS. Additionally, tobacco use appears to increase the need for subsequent surgical repair after meniscus or ACL injury