The Impact of Tobacco Use on Revision Total Knee Arthroplasty Outcomes

Smoking is associated with early postoperative adverse events, increased length of hospital stay, and an increased risk of revision after total knee arthroplasty (TKA). Smokers have an increased risk of earlier revision for any reason compared to nonsmokers. Smokers have an increased risk of earlier revision for any reason compared to ex-smokers. Smokers are at increased risk of earlier revision TKA (rTKA) when compared to nonsmokers and ex-smokers. The risk for ex-smokers is similar to that of nonsmokers. Smoking seems to have an all-or-none impact on earlier rTKA as individuals who smoke more do not have higher risk of early rTKA. Physicians must urge individuals not to start smoking and encourage smokers to quit smoking prior to TKA.