Knee Replacement Revision Risk May Be Higher In Smokers: Study

Research suggests that smoking may be a notable factor in the risk of early knee implant failure, coming at a time when a number of knee implant systems sold in recent years are under increased scrutiny for high rates problems. 

The study was published in the October issue of the medical journal The Knee, indicating that current smokers faced higher rates of revision surgery than non-smokers or even former-smokers. Researchers also found that the length of time before a knee replacement revision was needed was shorter for smokers than non-smokers or ex-smokers.

Stanford University researchers looked at 619 revision procedures involving total knee arthroplasty (TKA) referred to one academic tertiary center, looking at smoking status compared to time to revision and other factors.

According to the findings, smokers had an increased risk of early knee revision surgery for any reason, compared to both non-smokers and ex-smokers. Previous studies have also linked smoking to an increased risk of early postoperative complications, increased hospital stays and an overall increased risk of revision surgery.

“Smoking appears to have an all-or-none effect on earlier revision TKA as patients who smoked more did not have higher risk of early revision TKA,” the researchers noted. “These results highlight the need for clinicians to urge patients not to begin smoking and encourage smokers to quit smoking prior to primary TKA.”

The study did not look at reasons why smoking may cause knee implant failures at a higher rate, but comes as a number of knee implants face claims of high failure rates, particularly due to tibial plate failures.

The complaints have led to a growing number of knee replacement lawsuits filed in recent months over problems associated with several different types of systems widely used in recent years.

Similar allegations involving tibial failures have also been cited in recent DePuy Attune Knee lawsuits, as well as complaints over the Exactech Optetrak Total Knee Replacement System, and the Arthrex iBalance knee system.