The effect of smoking on outcomes following primary total hip and knee arthroplasty: a population-based cohort study of 117,024 patients

Acta Orthopaedica
Gulraj S MatharuHemant G Pandit

Abstract

Background and purpose - Smoking is a modifiable risk factor that may adversely affect postoperative outcomes. Healthcare providers are increasingly denying smokers access to total hip and knee arthroplasty (THA and TKA) until they stop smoking. Evidence supporting this is unclear. We assessed the effect of smoking on outcomes following arthroplasty.Patients and methods - We identified THAs and TKAs from the Clinical Practice Research Datalink, which were linked with datasets from Hospital Episode Statistics and the Office for National Statistics to identify outcomes. The effect of smoking on postoperative outcomes (complications, medications, revision, mortality, patient-reported outcome measures [PROMs]) was assessed using adjusted regression models.Results - We studied 60,812 THAs and 56,212 TKAs (11% smokers, 33% ex-smokers, 57% non-smokers). Following THA, smokers had an increased risk of lower respiratory tract infection (LRTI) and myocardial infarction compared with non-smokers and ex-smokers. Following TKA, smokers had an increased risk of LRTI compared with non-smokers. Compared with non-smokers (THA relative risk ratio [RRR] = 0.65; 95% CI = 0.61-0.69; TKA RRR = 0.82; CI = 0.78-0.86) and ex-smokers (THR RRR = 0.90; CI...Continue Reading

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Citations

May 11, 2020·Archives of Orthopaedic and Trauma Surgery·Alexandra Margarete PöllUwe Hamsen
Aug 9, 2020·Tobacco Induced Diseases·Chen JiangMingxuan Xie
Jan 3, 2020·Journal of Clinical Gastroenterology·Ryunosuke HakutaKazuhiko Koike
May 7, 2021·Journal of Inflammation·Thomas NicholsonSimon W Jones
Oct 14, 2021·International Journal for Equity in Health·Sebastian Ryan-NdegwaMohammad Akrami
Dec 9, 2021·Journal of Orthopaedic Surgery·Rex Wang-Fung MakKevin Ki-Wai Ho

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Methods Mentioned

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total hip arthroplasty

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