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Title

Strong association between smoking and the risk of revision in a cohort study of patients with metal-on-metal total hip arthroplasty

Authors
Rothman, Kenneth J
Published in Journal of Orthopaedic Research. 2014, vol. 32, no. 6, p. 762-8
Abstract Thus far the ability to predict who will develop early failure following the insertion of a metal-on-metal (MoM) bearing has been very limited. Our objective was to assess the effect of smoking on failure rates in patients with MoM bearing, compared with patients with ceramic-on-polyethylene (CoP) bearing. From a prospective hospital-based registry we included all primary THAs operated upon between 1/2001 and 12/2011 with MoM or CoP bearings of the same cup design and head size (28 mm). We compared revision rates through 10/2013 classified by smoking status and type of bearing. We included 1,964 patients (median age 71, 57% women), 663 with MoM and 1,301 with CoP bearing. Mean follow-up was 6.9 years (range 1.8-12.8). Revisions were required for 56 THAs. In patients with MoM bearing the adjusted incidence rate of revision among ever-smokers was four times greater than among never-smokers (95% CI 1.4-10.9). Among those with CoP bearing, the rate ratio was only 1.3 (95% CI 0.6-2.5). We found a strong association between smoking and increased failure of MoM THAs. In contrast, the association was weak for patients with CoP bearing. Smoking might be a trigger or an effect amplifier for adverse reactions to metal debris from MoM bearings. © 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 32:762-768, 2014.
Identifiers
PMID: 24615914
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Article (Published version) (83 Kb) - document accessible for UNIGE members only Limited access to UNIGE
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Research group Chirurgie orthopédique et traumatologique (98)
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(ISO format)
LUEBBEKE-WOLFF, Anne et al. Strong association between smoking and the risk of revision in a cohort study of patients with metal-on-metal total hip arthroplasty. In: Journal of Orthopaedic Research, 2014, vol. 32, n° 6, p. 762-8. https://archive-ouverte.unige.ch/unige:35877

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Deposited on : 2014-04-22

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