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Smoking increases reoperation rates after joint replacement

Smokers are more likely to need another operation following an infection within 90 days of a joint replacement than non-smokers, according to American research that included 6,749 male and 8,515 female patients.

Total hip arthroplasties accounted for 51.3 per cent of joint replacements and total knee arthroplasties for the remainder. Of those enrolled, 9.0 per cent were current smokers and 34.0 per cent former smokers. Overall, 0.83 per cent of patients were readmitted within 90 days of their joint replacement for non-operative reasons, such as wound complications and venous thromboembolic events, and 2.6 per cent were readmitted within 90 days for another operation.

Within 90 days of the first procedure, 1.2 per cent of smokers and 0.56 per cent of non-smokers underwent another operation for infectious complications. After adjustment, current smokers were 80 per cent more likely than non-smokers to need another operation to treat an infection. Former smokers were not at increased risk of needing another operation for infectious complications, the authors comment.

The study shows the importance of counselling patients about potential post-surgical risks associated with smoking, they add. Further research should examine whether smoking cessation influences the rate of complications after total joint arthroplasty.

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