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Meta-Analysis
. 2015 Apr 24;10(4):e0125294.
doi: 10.1371/journal.pone.0125294. eCollection 2015.

Smoking and risk of prosthesis-related complications after total hip arthroplasty: a meta-analysis of cohort studies

Songsong Teng  1 , Chengqing Yi  2 , Christian Krettek  3 , Michael Jagodzinski  4
Affiliations
Meta-Analysis

Smoking and risk of prosthesis-related complications after total hip arthroplasty: a meta-analysis of cohort studies

Songsong Teng et al. PLoS One. .

Abstract

Objective: Increasing evidence suggests that smoking may increase the incidence of prosthesis-related complications after total hip arthroplasty (THA). We performed a meta-analysis of cohort studies to quantitatively evaluate the association between smoking and the risk of prosthesis-related complications after THA.

Methods: Relevant articles published before August 15, 2014, were identified by searching the PubMed, EMBASE and Cochrane library databases. Pooled risk ratios (RRs) or weighted mean differences (WMDs) with 95% confidence intervals (CIs) were calculated with either a fixed- or random-effects model.

Results: Six cohort studies, involving a total of 8181 participants, were included in the meta-analysis. Compared with the patients who never smoked, smokers had a significantly increased risk of aseptic loosening of prosthesis (summary RR=3.05, 95% CI: 1.42-6.58), deep infection (summary RR=3.71, 95% CI: 1.86-7.41) and all-cause revisions (summary RR=2.58, 95% CI: 1.27-5.22). However, no significant difference in the risk of implant dislocation (summary RR= 1.27, 95% CI: 0.77-2.10) or length of hospital stay (WMD=0.03, 95% CI: -0.65-0.72) was found between smokers and nonsmokers.

Conclusions: Smoking is associated with a significantly increased risk of aseptic loosening of prosthesis, deep infection and all-cause revisions after THA, but smoking is not correlated with a risk of implant dislocation or the length of hospital stay after surgery.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of the assessment and selection of publications for the meta-analysis.
Fig 2
Fig 2. Forest plot of the association between smoking and the risk of aseptic loosening of prosthesis after total hip arthroplasty.
Fig 3
Fig 3. Forest plots of the association between smoking (A), current smoker (B), former smoker (C) and the risk of deep infection after total hip arthroplasty.
Fig 4
Fig 4. Forest plot of the association between smoking and the risk of implant dislocation after total hip arthroplasty.
Fig 5
Fig 5. Forest plot of the association between smoking and the risk of all-cause revisions after total hip arthroplasty.
Fig 6
Fig 6. Forest plot of the association between smoking and the length of hospital stay after total hip arthroplasty.
See this image and copyright information in PMC

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