Smoking Associated with Knee Replacement Failure

Post provided by the American Academy of Orthopaedic Surgeons

Tobacco and nicotine use are known to impair the body’s ability to heal bones and wounds. A new study presented at the 2012 Annual Meeting of the American Academy of Orthopaedic Surgeons looked at the effects of smoking on total joint replacement. 

The study on total knee replacement (TKR) surgery had a 10-fold higher revision rate compared to non-smokers. The investigation involved 621 TKR patients, including 131 smokers (median age 62). All patients who were smokers were encouraged to participate in a smoking cessation program prior to TKR surgery. Clinical outcomes, including pain, function and range of motion, were assessed following surgery in both groups. The smoking group had 13 knee replacement failures (10 percent) compared to five in the non-smoking group (1 percent). The medical complication rate also was “significantly higher” in the smoking group, with 27 patients (21 percent) having a medical complication compared to 60 (12 percent) of non-smokers. Complications included deep venous thrombosis (DVT) or blood clots, anemia requiring treatment, cardiac problems, and acute renal failure. Investigators recommend that patients stop or minimize nicotine use prior to TKR.