Tobacco use is a risk factor for prosthetic joint infection after total hip arthroplasty

  • Bojan B & al.
  • Arthroplast Today
  • 1 Dec 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Tobacco use was associated with an increased risk of developing prosthetic joint infections (PJIs), particularly deep infection or infection requiring revision surgery in patients undergoing total hip arthroplasty (THA).

Why this matters

  • Findings reflect the recommendation of tobacco use cessation before THA.
  • Additional preventive measurements are advisable when tobacco users undergo THA to reduce the likelihood of PJIs.

Study design

  • Meta-analysis of 10 case-control studies including 20,640 patients undergoing THA (5328, tobacco users; 15,312 nonusers).
  • Funding: None.

Key results

  • The pooled OR of developing a superficial infection, a deep infection, or an infection requiring revision surgery for tobacco users vs non-users was 1.54 (95% CI, 1.25-1.91; P<.0001 when a fixed-effect model was used and ci p=".0005)" random-effect used.>
  • When individual outcomes were considered, tobacco use was associated with an increased of:
    • deep infections (7 studies; pooled OR, 1.81; 95% CI, 1.39-2.36); and
    • infection requiring revision surgery (5 studies; pooled OR, 2.02; 95% CI, 1.16-3.51).
  • Tobacco use was not significantly associated with superficial infections after THA (4 studies; pooled OR, 0.89; 95% CI, 0.58-1.37).

Limitations

  • Heterogeneity among studies.