Smoking Complicates Joint Replacement Outcomes

Smokers undergoing total hip or knee replacement should be counseled to quit

MONDAY, Oct. 3 (HealthDay News) -- Smoking is associated with higher rates of complications such as infections, stroke, pneumonia, and death following elective total hip replacement (THR) and total knee replacement (TKR) surgeries, according to research published in the October issue of Arthritis Care & Research.

Jasvinder A. Singh, M.P.H., of the VA Birmingham Medical Center in Alabama, and colleagues looked at data from the national Veterans Affairs Surgical Quality Improvement Program to examine associations between smoking and outcomes in 33,336 patients who underwent THR or TKR.

The researchers found that 57 percent had never smoked, 19 percent no longer smoked, and 24 percent currently smoked. Current smokers were significantly more likely than those who had never smoked to experience surgical site infections (odds ratio [OR], 1.41), pneumonia (OR, 1.53), stroke (OR, 2.61), or death within one year (OR, 1.63). Compared to nonsmokers, prior smokers were significantly more likely to experience pneumonia (OR, 1.34), stroke (OR, 2.14), and urinary tract infections (OR, 1.26).

"Current smoking at the time of elective THR or TKR is associated with increased postarthroplasty complications, especially surgical site infections and pneumonia. Preoperative smoking cessation programs should be considered in patients undergoing elective THR or TKR," the authors write.

Two authors disclosed financial relationships with pharmaceutical companies.

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