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Archives of Orthopaedic and Trauma Surgery

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Open Access 13-01-2023 | Orthopaedic Surgery

Smokers have increased risk of soft-tissue complications following primary elective TKA

Authors: Moritz Starzer, Maria Anna Smolle, Ines Vielgut, Georg Hauer, Lukas Leitner, Roman Radl, Reinhard Ehall, Andreas Leithner, Patrick Sadoghi

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 8/2023

Abstract

Introduction

Smoking has been associated with numerous adverse outcomes following surgical procedures. The purpose of this study was to investigate, whether smoking status at time of surgery influences the outcome of primary TKA.

Materials and methods

Six hundred and eighty-one patients who underwent primary TKA between 2003 and 2006 were included in the study. Smoking status was defined as current, former, and never smoker. Complications leading to revisions were assessed until 17 years of follow-up. Functional outcome was evaluated using clinical scores: Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual Analogue Scale (VAS) for pain, Short Form-12 Physical and Mental Component Summaries (SF-12PCS/MCS), and Knee Society Function and Knee Score (KSFS and KSKS).

Results

At a mean follow-up of 95 months (± 47 months), 124 complications led to revision surgery. Soft-tissue complications (OR, 2.35 [95% CI 1.08–5.11]; p = 0.032), hematoma formation (OR, 5.37 [95% CI 1.01–28.49]; p = 0.048), and restricted movement (OR, 3.51 [95% CI 1.25–9.84]; p = 0.017) were more likely to occur in current smokers than never smokers. Current smokers were more likely to score higher at KSFS (p < 0.001) and SF-12PCS (p = 0.0197) compared to never smokers. For overall revision, differences were noted.

Conclusion

Current smoking increases risk of soft-tissue complications and revision after primary TKA, especially due to hematoma and restricted movement. Smoking cessation programs could reduce the risk of revision surgery.

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Title: Smokers have increased risk of soft-tissue complications following primary elective TKA
Authors: Moritz Starzer
Maria Anna Smolle
Ines Vielgut
Georg Hauer
Lukas Leitner
Roman Radl
Reinhard Ehall
Andreas Leithner
Patrick Sadoghi
Publication date: 13-01-2023
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 8/2023
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-023-04771-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Smokers have increased risk of soft-tissue complications following primary elective TKA

Abstract

Introduction

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

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