Early aseptic loosening of cemented total hip arthroplasty: the influence of non-steroidal anti-inflammatory drugs and smoking

Malik, M. H. A.; Gray, Julie McLaughlin; Kay, PR

doi:10.1007/s00264-004-0556-z

Cited by 20 publications

(26 citation statements)

References 29 publications

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“…21 studies from the original search met the inclusion and exclusion criteria and data were extracted from these. Of the 21 included studies 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65, 13 included patients with THA 45,49-54,56,59-63 , 4 with TKA 47,55,58,64 , 3 with patients THA or THA 46,48,57 and 1 was a statistical modeling exercise 65 . No additional studies were identified from the reference lists of included studies.…”

Section: Resultsmentioning

confidence: 99%

“…Table 1 summarizes demographic characteristics of patient populations in the included 21 observational studies 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65, of which one was a statistical modeling study 65 (which provided no usable data). Most studies compared smokers to non-smokers, with few studies categorizing patients into former, current and non-smokers.…”

Section: Resultsmentioning

confidence: 99%

“…We present data from studies that provided multivariable analyses 45464748495051 followed by those that performed univariate analyses 52535455565758596061626364 . The quality score for each study is based on the Newcastle-Ottawa scale (range, 0-9) provided in Table 2.…”

Section: Resultsmentioning

confidence: 99%

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Smoking and Outcomes After Knee and Hip Arthroplasty: A Systematic Review

Singh¹

2011

J Rheumatol

178

100

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Background Studies have suggested higher rates of peri- and post-operative complications in smokers compared to non-smokers. The objective of this systematic review was to assess the association of smoking and post-operative outcomes following total hip arthroplasty (THA) or total knee arthroplasty (TKA). Methods A search of six databases (The Cochrane Library, Scopus, Proquest Dissertation abstracts, CINAHL, OVID MEDLINE and EMBASE) was performed by a Cochrane librarian. All titles and abstracts were screened by two independent reviewers, with expertise in performing systematic reviews. Studies were included if they were fully published reports that included smoking and any perior post-operative clinical outcome in patients with either TKA or THA. Results 21 studies were included for the review, of which six included multivariable-adjusted analyses, 14 univariate analyses and one statistical modeling. For most outcomes, results from 1-2 studies could be pooled. Current smokers were significantly more likely to have any post-operative complication (risk ratio, 1.24 [95% confidence interval, 1.01 to 1.54]) and death (risk ratio, 1.63 [95% confidence interval, 1.06 to 2.51]), compared to non-smokers. Former smokers were significantly more likely to have any post-operative complication (risk ratio, 1.32 [95% confidence interval, 1.05 to 1.66]) and death (risk ratio, 1.69 [95% confidence interval, 1.08 to 2.64]). Conclusion This systematic review finds that smoking is associated with significantly higher risk of post-operative complication and mortality following THA or TKA. Studies examining long-term consequences of smoking on implant survival and complications are needed. Smoking cessation may improve outcomes after THA or TKA.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Smoking and Outcomes After Knee and Hip Arthroplasty: A Systematic Review

Singh¹

2011

J Rheumatol

178

100

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“…Two studies in orthopaedic surgery reported that smoking was an independent risk factor for SSI, but they are retrospective observational studies with few patients, 69 and 50 respectively [4,5]. In retrospective studies, using multivariate logistic regression analysis, smoking history was not recovered as a risk factor for SSI in 223 patients underlying spine surgery [6], nor as a risk factor for aseptic loosening around total hip arthroplasty [15]. In a retrospective study including 34 patients with 37 operations, smoking was significantly associated with failure of operative treatment of established non-union of the scaphoid bone [16].…”

Section: Discussionmentioning

confidence: 99%

Smoking is a risk factor of organ/space surgical site infection in orthopaedic surgery with implant materials

Durand

Berthelot

Cazorla

et al. 2013

International Orthopaedics (SICOT)

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Purpose In recent guidelines, smoking is reported as a factor increasing the risk of surgical site infection (SSI). The accurate analysis of the literature shows that this recommendation relies on low level of evidence in orthopaedic surgery with material implantation (arthroplasty components or implants for internal fixation). This study aimed to assess the attributable risk of smoking on organ/space SSI in orthopaedic surgery with implants. Methods Risk factors of organ/space SSI were studied in a prospective cohort including 3,908 patients from June 2003 to December 2006. Results Smoking was found as a significant risk factor for organ/space SSI. We also observed a significant difference between smokers and non-smokers for surgical wound complications (hematoma, discharge or wound dehiscence) during the period between surgical procedure and discharge from hospital. Conclusion This is the first large prospective report of a significant association between smoking and organ/space SSI in orthopaedic surgery with implants.

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“…Among modifiable risk factors, multiple factors such as high activity level [3,14,17,30,43,44,48], obesity [2,9,10,34,37,38,43,46,48,51,52], and smoking [10,12,16,17,19,32,35,41] may be associated with an increase in the risk of aseptic loosening after THA.…”

Section: Discussionmentioning

confidence: 99%

What Host Factors Affect Aseptic Loosening After THA and TKA?

Cherian

Jauregui

Banerjee

et al. 2015

Clinical Orthopaedics &Amp; Related Research

175

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Background Aseptic loosening is the most common cause for revisions after lower-extremity total joint arthroplasties, however studies differ regarding the degree to which host factors influence loosening. Questions/purpose We performed a systematic review to determine which host factors play a role in the development of clinical and/or radiographic failure from aseptic loosening after (1) THA and (2) TKA. Methods Two searches on THA and TKA, respectively, using four electronic databases (EMBASE, CINAHL Plus, PubMed, and Scopus) were conducted. We identified a total of 209 reports that encompassed nine potential host factors affecting aseptic loosening. Inclusion criteria for consideration of scientific clinical reports were that 20 or more patients were involved, with more than 1-year followup, with at least three studies pertaining to each factor, and at least six of the Methodological Index for Non-randomized Studies criteria met, and with raw data for odds ratio (OR) calculations. Twenty-one studies (16 THA studies with 45,779 hips and five TKA studies with 288 knees, respectively) were used to calculate weighted OR and CIs (using the random effects theory) and study heterogeneity for four different host factors in THAs (male sex, high activity level, obesity defined as BMI C 30 kg/m 2 , and current or former tobacco use) and one factor in TKA (BMI C 30 kg/m 2 ), which were placed in a forest plot. Results For THA, male sex (OR, 1.39; 95% CI, 1.22-1.58; p = 0.001) and high activity level (University of California Los Angeles [UCLA] activity score C 8 points; OR, 4.24; 95% CI, 2.46-7.31; p = 0.001) were associated with aseptic loosening. However, obesity (OR, 1.01; 95% CI, 0.73-1.40; p = 0.96), and tobacco use (OR, 1.96; 95% CI, 0.43-8.97; p = 0.39) were not associated with an increased risk of aseptic loosening after THA with the numbers available. For TKA, we found no host factors associated with loosening. In particular, obesity (BMI C 30 kg/m 2

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Early aseptic loosening of cemented total hip arthroplasty: the influence of non-steroidal anti-inflammatory drugs and smoking

Abstract: The purpose of this study was to investigate whether the clinical variables of non-steroidal anti-

Cited by 20 publications

References 29 publications

Smoking and Outcomes After Knee and Hip Arthroplasty: A Systematic Review

Smoking and Outcomes After Knee and Hip Arthroplasty: A Systematic Review

Smoking is a risk factor of organ/space surgical site infection in orthopaedic surgery with implant materials

What Host Factors Affect Aseptic Loosening After THA and TKA?

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