Joint-Replacement Failure Rate Higher for Smokers:
FRIDAY, April 20 (HealthDay News) -- Knee and hip replacements
are more likely to fail in smokers than nonsmokers, according to
two new studies.
One study of 621 patients, including 131 smokers, who underwent
total knee replacement found that the rate of knee-replacement
failure was 10 times higher among smokers than nonsmokers -- 10
percent vs. 1 percent.
Smokers also had a higher rate of medical complications than
nonsmokers -- 21 percent vs. 12 percent. Complications included
blood clots, anemia, heart problems and acute kidney failure.
The second study included hundreds of patients who underwent
reconstruction of the acetabulum (the cup-shaped cavity at the base
of the hip bone) with ultraporous metal, which is said to result in
fewer failures than standard metal. The failure rate in smokers was
9.1 percent, compared to 3.4 percent in nonsmokers.
The studies were presented recently at the annual meeting of the
American Academy of Orthopaedic Surgeons in San Francisco, which
also included a forum on smoking and joint replacement.
At the forum, experts offered suggestions about how to get
patients to quit smoking. One way is to refuse to perform surgery
on patients who smoke, said Dr. Glenn Rechtine, an orthopedic
surgeon and associate chief of staff and adjunct professor at the
University of South Florida in Tampa. He said this rule has
convinced 40 percent of his patients to stop smoking.
A three-step process has been effective for Dr. Richard Hurt,
professor of medicine and director of the Nicotine Dependence
Center at the Mayo Clinic in Rochester, Minn.
"First, ask about tobacco use," Hurt said in an academy news release. "Have your receptionist ask, your nurse ask, your physician's assistant ask, and you ask -- even if you already know the answer. Asking shows the patient that smoking is a serious problem that must be addressed. Then, advise the patient to stop smoking. Don't just say, 'you know, you ought to consider stopping someday.' Tell the patient, 'you need to stop smoking.' Finally, because smokers are going to push back, it's important to offer help."
Data and conclusions presented at medical meetings should be
considered preliminary until published in a peer-reviewed medical
The U.S. National Institute of Arthritis and Musculoskeletal and
Skin Diseases has more about
joint replacement surgery.
Copyright © 2012
. All rights reserved.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.