Abstract
Background
The purpose of this study was to perform a systematic review and meta-analysis to
quantitatively assess the association between tobacco use and the risk of any wound
complication and periprosthetic joint infection (PJI) after primary total hip and
total knee arthroplasty procedures.
Methods
Relevant articles published before January 2018 were identified by systematically
searching PubMed, EMBASE, and Cochrane library databases. Pooled odds ratios (OR)
and 95% confidence intervals were calculated for end points of any wound complication
and PJI. Additional analyses were performed to evaluate risks between current, former,
and non–tobacco users.
Results
Fourteen studies were included in the meta-analysis. Tobacco users had a significantly
higher risk of wound complications (OR, 1.78 [1.32-2.39]) and PJI (OR, 2.02 [1.47-2.77])
compared to non–tobacco users. Compared to non–tobacco users, there was an increased
risk of PJI among current (OR, 2.16 [1.57-2.97] and former (OR, 1.52 [1.16-1.99])
tobacco users. Current tobacco users also had a significantly increased risk of PJI
compared to former tobacco users (OR, 1.52 [1.07-2.14]).
Conclusion
Tobacco use before total hip and total knee arthroplasty significantly increases the
risk of wound complications and PJI. This increased risk is present for both current
and former tobacco users. However, former tobacco users had a significantly lower
risk of wound complications and PJI compared to current tobacco users, suggesting
that cessation of tobacco use before TJA can help to mitigate these observed risks.
Keywords
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Article info
Publication history
Published online: October 09, 2018
Accepted:
September 27,
2018
Received in revised form:
September 26,
2018
Received:
June 22,
2018
Footnotes
One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to https://doi.org/10.1016/j.arth.2018.09.089.
Identification
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© 2018 Elsevier Inc. All rights reserved.
