Jeff Stickney, MD

Board Certified Orthopedic Surgeon

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Smoking Increases Risk of Postoperative Complications


smoking-surgical-riskThe adverse effects of smoking upon a patient’s health have been known for decades. However, the relationship between smoking and postoperative complications for total joint arthroplasty has, until recently, been unclear. As total joint arthroplasty, a treatment for degenerative joint disease, is expected to increase in frequency in the United States, the medical community has been interested in potential risk factors, such as smoking. A recent study performed at The Rothman Institute at Thomas Jefferson University has found definitive evidence that current smokers, as well as former smokers, are at significantly higher risk of postoperative complications after joint replacement than non-smokers.

This recent research, published in The Journal of Bone and Joint Surgery, Inc, studied 15,264 patients who underwent 17,394 total joint arthroplasties between 2000 and 2014. The team sought to determine if smoking impacted whether or not a patient faced readmission and/or reoperation within 90 days of the first surgery.

Of the patients surveyed, 9% currently smoked, 34% had formerly smoked (on average, they had quit 22 years before), and 57% were nonsmokers. While the average age of the latter group was 63.2 years, current smokers needed surgery at an average of 57.7 years. The researchers also analyzed packs smoked per decades — an average of 233 for current smokers and 221.1 for former smokers.

Hip and knee surgical risk factors are impacted by patients who smoke. The researchers’ findings show current smokers bring higher surgical risk factors that nonsmokers; they were much more likely to need reoperation for infection within 90 days of the original procedure. Smoking, regardless of current status, also led to significantly higher rates of unplanned nonoperative readmission. The more packs smoked per decade, the more these potential complications increased.

Tobacco use is the largest preventable cause of disease and death, triggering complications and risks even after a user has quit. Knowing the dangers is crucial to leading a healthy life, whether now or several decades later, especially given its relationship to surgery outcome. It is likely insurance and medical practices may require smoking cessation prior to joint replacement surgery in the future.

Troubled by joint pain? Concerned about how smoking might be impacting your joints or joint surgery? Dr. Stickney, a Kirkland orthopedic surgeon, specializes in procedures including total knee replacement and shoulder replacement. Contact his office today to return to a healthy, active lifestyle.