Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Starzer, M.
Smoking as a risk factor of total knee arthroplasty
Humanmedizin; [ Diplomarbeit ] Medical University of Graz; 2021. pp. 77
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Sadoghi Patrick
- Smolle Maria Anna
- Altmetrics:
- Abstract:
- Background: Tobacco smoking has been associated with postoperative complications and an increased risk of earlier time to revision surgery after primary total knee arthroplasty (TKA). In Austria, no scientific evaluation of the outcome of tobacco smoking on TKA has been conducted, despite Austria being a country with a high prevalence of active smokers and a high incidence of TKAs. The aim of this study was to compare complication rates after primary TKA of smoking status groups (active smokers, former smokers, never smokers) in order to provide information about the influence of tobacco smoking on the outcome of TKA in Austria. Methods: A total of 681 patients who underwent primary TKA between 2003 and 2006 at the Department of Orthopedics and Orthopedic Surgery at the LKH Radkersburg, Austria, were retrospectively evaluated according to the patient smoking status. Complications and revisions were documented during the potential follow-up time of up to 17 years. Smoking status was then analyzed for associations with revision TKA using a Chi-square test. Postoperative functional outcome was measured using clinical scores: Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual Analogue Scale (VAS), Short-Form 12 Physical Component- and Mental Component Summary (SF-12PCS/MCS), Knee Society Score (KSS). Results: For the total amount of revisions, no statistically significant difference between active smokers, former smokers, and never smokers could be found. However, a tendency towards active smokers (13/46, 28.3%) having a higher risk of revision surgery than never smokers (103/596, 17.3%, p=0.062) was present without a statistical preference. Subgroup analysis revealed a higher risk of soft tissue complications for active smokers (9/46, 19.6%) in comparison to never smokers (56/596, 9.4%, p=0.028). Smokers scored higher at KSS function (p<0.001) and SF-12PCS (p=0.0197) than never smokers and reported higher pain ratings preoperatively (p=0.0031). Conclusion: Smoking causes an increased risk of revision surgery in case of active smokers compared to never smokers. Former smokers and never smokers had similar complication rates, indicating a benefit of smoking cessation on outcome after TKA. Our study shows a benefit in functional outcome after primary TKA regardless of smoking status.