Increased revision rates after total knee arthroplasty in patients who smoke

J Arthroplasty. 2012 Oct;27(9):1690-1695.e1. doi: 10.1016/j.arth.2012.03.057. Epub 2012 May 23.


The purpose of this study was to compare the clinical outcomes of total knee arthroplasty in patients who reported a history of tobacco use with those who were nonsmokers. Between 2006 and 2009, there were 131 total knee arthroplasties performed in patients who were smokers and 490 in patients who did not smoke. At a mean follow-up of 47 months (range, 24-79 months), the patients who were smokers had a statistically decreased overall survivorship of 90% (13 revisions) compared with 99% (5 revisions) in the nonsmokers. Surgical complication rates were not significantly different between the 2 groups; however, there was a significant difference in medical complications. Total knee arthroplasty in smokers has a higher risk of negative clinical outcomes compared with nonsmokers.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Arthroplasty, Replacement, Knee*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / surgery*
  • Reoperation / statistics & numerical data*
  • Risk Factors
  • Smoking / adverse effects*
  • Survival Rate
  • Treatment Outcome