Quit Smoking and Enjoy That New Hip

Total hip replacement patients heal better without cigarettes

/ Author:  / Reviewed by: Chris Galloway, M.D.

(RxWiki News) Total hip replacement and smoking cigarettes just don’t mix. That's because smoking can cramp the healing process. Even quitting just before surgery is better than not quitting at all.

Researchers recently studied a group of patients who had undergone total hip replacement surgery.

Patients who were current smokers had higher rates of infection, pain and loosened hip joints, which had to be corrected with a second surgery, compared to non-smokers.

"Quit smoking before hip replacement surgery."

At a recent conference, Bhaveen Kapadia, MD, from the Rubin Institute for Advanced Orthopaedics at Sinia Hospital in Baltimore, MD, and fellow researchers presented evidence on the impact of smoking on patients healing from hip surgery.

Previous studies have shown that smoking cigarettes can affect healthy blood flow. After total hip replacement, blood flow is vital to the healing process, according to the authors.

For the study, 110 smokers and twice as many non-smokers who had a total hip replacement between 2007 and 2009 were followed for two to six years after undergoing surgery. Patients ranged from 35 to 84 years of age.

Smokers were divided into three groups according to pack-years. A pack-year is defined as the number of years a person smoked multiplied by the number of packs he or she smoked per day. Smokers were placed in the ranges of: less than 20 pack-years, 21 to 40 pack-years and more than 40 pack-years.

The researchers looked at rates of infection, x-rays and how each patient rated function, healing, mobility and pain on the Harris Hip Score scale.

The hip replacement surgery had to be redone in nine smokers (8 percent) compared to only 1 percent of non-smokers.

Of the smokers who had to have their surgery redone, four patients had the second surgery due to pain or loosening of the hip joint and five patients had the second surgery because of an infection.

When the researchers compared smoking statuses, they found that 9 percent of current smokers had to have surgeries redone, compared to 4 percent of former smokers.

In the conclusion, the authors noted that tobacco and nicotine use has been known to limit good blood flow, which can increase the time it takes to heal from total hip replacement.

The authors found that smoking patients did not respond well to being prompted to quit smoking.

The authors recommended that healthcare professionals put forth effort to get patients to quit smoking before undergoing total hip replacement.

This study was presented at the annual meeting of the American Academy of Orthopaedic Surgeons (AAOS) in Chicago, IL, March 19-23, 2013. The results of this study have not been published in a peer-reviewed journal.

No funding information was made available to the public. No conflicts of interest were reported by the authors.

Reviewed by: 
Review Date: 
March 22, 2013
Last Updated:
March 25, 2013