Tobacco Use and Risk of Wound Complications and Periprosthetic Joint Infection: A Systematic Review and Meta-Analysis of Primary Total Joint Arthroplasty Procedures

Nicholas A Bedard; David E DeMik; Jessell M Owens; Natalie A Glass; Jennifer DeBerg; John J Callaghan

doi:10.1016/j.arth.2018.09.089

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Tobacco Use and Risk of Wound Complications and Periprosthetic Joint Infection: A Systematic Review and Meta-Analysis of Primary Total Joint Arthroplasty Procedures

Journal article

Peer reviewed

Tobacco Use and Risk of Wound Complications and Periprosthetic Joint Infection: A Systematic Review and Meta-Analysis of Primary Total Joint Arthroplasty Procedures

Nicholas A Bedard, David E DeMik, Jessell M Owens, Natalie A Glass, Jennifer DeBerg and John J Callaghan

The Journal of arthroplasty, Vol.34(2), pp.385-396.e4

02/2019

DOI: 10.1016/j.arth.2018.09.089

PMID: 30385090

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Abstract

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. 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. 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]). 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.

Tobacco

total hip arthroplasty

total knee arthroplasty

wound complications

smoking

prosthetic joint infection

Details

Title: Subtitle: Tobacco Use and Risk of Wound Complications and Periprosthetic Joint Infection: A Systematic Review and Meta-Analysis of Primary Total Joint Arthroplasty Procedures
Creators: Nicholas A Bedard - Department of Orthopaedic Surgery and Rehabilitation, University of Iowa, Iowa City, IA
David E DeMik - Department of Orthopaedic Surgery and Rehabilitation, University of Iowa, Iowa City, IA
Jessell M Owens - Department of Orthopaedic Surgery and Rehabilitation, University of Iowa, Iowa City, IA
Natalie A Glass - Department of Orthopaedic Surgery and Rehabilitation, University of Iowa, Iowa City, IA
Jennifer DeBerg - Hardin Library for the Health Sciences, University of Iowa Libraries, Iowa City, IA
John J Callaghan - Department of Orthopaedic Surgery and Rehabilitation, University of Iowa, Iowa City, IA
Resource Type: Journal article
Publication Details: The Journal of arthroplasty, Vol.34(2), pp.385-396.e4
DOI: 10.1016/j.arth.2018.09.089
PMID: 30385090
NLM abbreviation: J Arthroplasty
ISSN: 0883-5403
eISSN: 1532-8406
Publisher: Elsevier Inc
Language: English
Date published: 02/2019
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Orthopedics and Rehabilitation; Nursing; Hardin Library
Record Identifier: 9983993012602771

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