Roken is een risicofactor voor falen van primaire en revisie heupprotheses: stoppen dus?

Zelfs met de moderne technieken als ultra-poreuze coatings op de bekkenkomprothese is het risico op falen van de heupprothese verhoogd bij rokende patienten. Dit geldt voor zowel de primaire heupprothese als de revisie van een gefaalde heupprothese.

Adolph V. Lombardi, Jr., MD presenteerde deze studieresultaten op de meest recente American Academy of Orthopaedic Surgeons Annual Meeting in San Francisco. Op http://www.healio.com/orthopedics/hip/news/online/%7B5FF620DD-84F7-4FFC-91CA-8F87E311A10D%7D/Smoking-a-risk-factor-for-early-failure-in-primary-revision-THA staat vermeld:

Lombardi and his team looked at 10 years’ worth of hip procedures, identifying ultraporous acetabular component use in 535 hips in 500 patients. There were 160 complex primary and 375 revision cases in the cohort, according to the study abstract.

“As far as the patients’ history of smoking: 50% never smoked, 3% we were unable to determine, 17% were current smokers and 30% had prior smoking history,” Lombardi said.

The results of the study, Lombardi noted, indicate smoking is a significant risk factor in early failure.

“This is the nuts and bolts – reasons for failure,” he said. “Infection, aseptic loosening and periacetabular failure — all of which we believe may be affected by smoking.”

“As we looked at overall failure by smoking history, it was statistically significantly higher in our current and prior smokers vs. our never smokers,” he added.

According to the abstract, there were 33 failures at an average of 18 postoperative months. Lombardi noted a failure rate in smokers of 11%, with a failure rate of 3.8% in non-smokers and 5.3% in previous smokers.

“Our take-home message is that even with ultraporous technology, smoking seems to be a significant risk factor for early failure,” Lombardi said. “I think we should encourage our patients to quit smoking. It will reduce the risk, but not totally, and smoking cessation should be considered part of your preoperative education program.”

Lombardi AV, Berend KR, Morris MJ, et al. Smoking is a harbinger of early failure with ultraporous metal acetabular reconstruction. Paper #223. Presented at the American Academy of Orthopaedic Surgeons Annual Meeting. Feb. 7-11, 2012. San Francisco.