Does smoking affect implant survivorship in total hip arthroplasty? A preliminary retrospective case series

This retrospective study aimed to explore the effects of smoking on hip implant survivorship. The study included 147 patients (165 hips) from 1985 to 1991 who underwent total hip arthroplasty (THA) with a particular uncemented cup, and either a cemented or uncemented femoral component of the same design. Thirty-one patients (34 hips, 21 percent of study group) smoked at the time of surgery. Of 13 components (seven cups, five cemented and one cementless stem) revised for aseptic loosening, eight (8/68, 11.8 percent) were revised in six smokers, and five (5/262, 1.9 percent) were revised in four nonsmokers (p = 0.0012). Multivariate covariate analysis revealed a 4.5 times greater risk of implant loosening in smokers (p = 0.0662). Based on this preliminary study, further larger studies should be performed to determine the extent that smoking may contribute to THA survivorship.