Quit it: new study finds quitting smoking cuts complications after knee replacement surgery

If you’re a smoker and were looking for a reason – yet another reason – to give up, here it is: according to a preliminary study conducted by the Department of Orthopaedic Surgery at the NYU Langone Medical Center, smokers who needed a hip or knee replacement fared better in surgical outcomes and experienced less adverse events – including hospital readmissions, surgical site infections and blood clots – if they enrolled in a smoking cessation programme beforehand.

Smoking and knee replacement: the nub of the matter

The study, which included over 500 smokers who had undergone total knee or hip replacement surgery, featured 100 smokers who had gone through a smoking-cessation programme which consisted of four counselling sessions over the phone and the option to receive nicotine replacement therapy if required. The key findings of the study include:

• Smokers who had undergone the cessation programme prior to surgery had better surgical outcomes
• The new non-smokers had lower rates of problems post-surgery
• During total joint replacement surgery, the smokers were 50% more likely to develop complications during surgery
• The people in the study who continued to smoke within a month of surgery were more than twice as likely to develop a deep surgical infection compared to those who didn’t smoke

The people behind the study are the first to admit the limitations of their study – chiefly, the absence of chemical testing to determine that the ‘non-smokers’ were actually tobacco-free and not just saying they’d given up – but a larger study of 900 people is already underway, and we’ll be following it with interest.

Weight is an issue, too

However, there are other lifestyle factors that need to be adopted by people, especially as they get older, if they want to give themselves the best possible chance of a successful outcome of a joint replacement surgical procedure. In fact, a study presented at the same time in the Journal of Bone and Joint Surgery recommended a procedure of bariatric surgery – either through gastric band surgery or partial stomach removal – for morbidly obese patients who suffered from end-stage osteoarthritis.

Using a computer model to analyse past data on obesity, bariatric surgery and total knee replacement procedures, the study compared the costs and results on morbidly obese people who underwent bariatric surgery before total knee replacement surgery, and those who didn’t. The results? The patients who went through bariatric surgery two years before total knee replacement were more likely to enjoy an improved quality of life post-surgery.

Obviously, this is a no-brainer of a conclusion for a number of reasons, but it adds weight to the theory that if you’re in need of joint replacement surgery, it makes sense to ensure that the rest of your body is in as good a shape as possible to give you a fighting chance of recovery from the procedure – and also delay the need for such surgery in the first place.