[Smoking and alcohol abuse, risk factors of aseptic instability of hip endoprostheses]

Effect of smoking and alcohol abuse as risk factors of aseptic instability of endoprostheses was evaluated from mass dynamics of bone tissue bordering the grafts. The assessments were made in 188 patients during the period of adaptive restructuring of the bone tissue, i.e., within 15 months after surgery. Smoking and alcohol abuse were shown to slow down adequate increment of bone tissue mass in the proximal Gruen's zones during the second phase of restructuring. Patients of either sex failed to regenerate the tissue lost in the stress-shielding period unlike subjects of the control group. Moreover, the deficiency of bone tissue mass in these zones persisted within 15 months after surgery. Adverse effect of smoking on the initial conditions of bone tissue was more pronounced in men than in women. The reverse was true as far as the alcohol effect is concerned. Poor recovery of bone tissue mass around the endoprosthesis enhances its micromobility and may be a cause of its aseptic instability.