Smoking and mouse MCL healing.

Cigarette smoking has been shown to delay soft tissue healing and complicate musculoskeletal recovery. Its deleterious effects have been proven in bone and soft tissue, although to a much more limited fashion in ligament or tendon. We exposed 120 experimental mice to two cigarettes per day for 2 months and then induced a blunt medial collateral ligament (MCL) injury. Mice were assigned to three groups: the first group exposed to two cigarettes per day after injury, the second group exposed to one cigarette per day after injury, and the third group not exposed after injury. A fourth, no-smoking group served as control. The cut and contralateral intact ligaments were biomechanically tested to failure at 7 and 28 days. The ligaments of mice exposed to cigarette smoke were weaker (p = 0.02) and less stiff (p = 0.0004) at 28 days (3.2 N, 3.5 N/mm) compared with those of mice exposed to cigarette smoke for 7 days (3.9 N, 4.7 N/mm). The ligaments of mice exposed to cigarette smoke were weaker (p = 0.02) and less stiff (p = 0.01) at 28 days compared with control mice at 28 days. Between 7 and 28 days, smoking had a deleterious effect on healing manifested as weaker and less stiff ligaments. However, our findings did not support a dose-dependent effect of cigarette exposure on the tensile mechanical properties of ligaments.