Knee and Hip Replacements Fail At Higher Rate for Smokers: Study

Smoking may be a factor in the long-term success or failure of a hip and knee replacement system, according to two new studies. 

At the 2012 Annual Meeting of the American Acacemy of Orthopaedic Surgeons last week, researchers presented the findings of two studies, one focusing on hip replacement systems and the other focusing on knee replacement systems, both of which found an increased rate of implant failure, complications and the need for revision surgery among individuals who smoke.

The knee replacement study found that smokers were 10 times as likely to need their system removed than those that do not smoke. Researchers looked at 621 recipients of total knee replacements, including 131 who smoked. They found that the group of smokers had 13 knee replacement failures, representing 10% of the total population. That compared to only five knee failures among the non-smoking group.

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Among smokers, the rate of knee replacement complications was also high, with 21% suffering some kind of problem with their implant, compared to 12% for the non-smokers. Complications included blood clots, deep vein thrombosis (DVT), kidney failure, anemia and heart problems.

The other study, looking at hip replacement systems received by 533 recipients, found that smokers have a failure rate of 9.1%, almost three times that of the rate of hip implant failures suffered by 3.4% of non smokers.

In both cases, researchers recommended that patients quit smoking before undergoing a hip or knee replacement surgery.


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