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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2015

Open Access 01-12-2015 | Research article

Effect of smoking and soft tissue release on risk of revision after total knee arthroplasty: a case- control study

Authors: Benedict U. Nwachukwu, Ellen B. Gurary, Vladislav Lerner, Jamie E. Collins, Thomas S. Thornhill, Elena Losina, Jeffrey N. Katz

Published in: BMC Musculoskeletal Disorders | Issue 1/2015

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Abstract

Background

Increasing utilization of primary total knee arthroplasty (TKA) is projected to expand demand for revision TKA. Revision TKAs are procedurally complex and incur high costs on our financially constrained healthcare system. The purpose of this study was to use a case-control design to identify factors predisposing to revision TKA, particularly demographic, clinical and perioperative technical factors.

Methods

We conducted a case control study to investigate patient, surgical and perioperative factors associated with greater risk of revision TKA. We included patients who received TKA at a tertiary center between 1996 and 2009. Cases (patients that had primary and revision TKA) were matched to controls (patients with primary TKA that was not revised) in a 1:2 ratio and risk of revision examined using conditional logistic regression.

Results

We identified 146 cases and 290 controls. Patient factors independently associated with revision included male sex (OR 1.73; 95 % CI 1.06-2.81) and smoking (OR 2.87; 1.33-6.19). Older age was associated with decreased risk (OR 0.83 per 5-year increment; 95 % CI 0.75-0.92). Lateral release was the only technical factor associated with revision (OR 1.92; 1.07-3.43).

Conclusions

In this case control study younger patient age, male gender, soft tissue release and active smoking status were associated with increased revision risk. Although we do not know whether the risk of smoking arises from short- or long-term exposure, smoking cessation prior to TKA should be considered as an intervention for decreasing revision risk.
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Metadata
Title
Effect of smoking and soft tissue release on risk of revision after total knee arthroplasty: a case- control study
Authors
Benedict U. Nwachukwu
Ellen B. Gurary
Vladislav Lerner
Jamie E. Collins
Thomas S. Thornhill
Elena Losina
Jeffrey N. Katz
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2015
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-015-0694-z

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