Kim BI, O'Donnell J, Wixted CM, Seyler TM, Jiranek WA, Bolognesi MP, Ryan SP. Smoking cessation prior to elective total joint arthroplasty results in sustained abstinence postoperatively. World J Orthop 2024; 15(7): 627-634 [PMID: 39070934 DOI: 10.5312/wjo.v15.i7.627]
Corresponding Author of This Article
Sean Patrick Ryan, MD, Assistant Professor, Department of Orthopedic Surgery, Duke University Hospital, 5601 Arringdon Park Dr. Suite 300, Durham, NC 27560, United States. sean.p.ryan@duke.edu
Research Domain of This Article
Orthopedics
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Jul 18, 2024; 15(7): 627-634 Published online Jul 18, 2024. doi: 10.5312/wjo.v15.i7.627
Smoking cessation prior to elective total joint arthroplasty results in sustained abstinence postoperatively
Billy Insup Kim, Jeffrey O'Donnell, Colleen M Wixted, Thorsten Markus Seyler, William A Jiranek, Michael Paul Bolognesi, Sean Patrick Ryan
Billy Insup Kim, Jeffrey O'Donnell, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY 10021, United States
Colleen M Wixted, Department of Orthopedic Surgery, New York University, New York, NY 10003, United States
Thorsten Markus Seyler, William A Jiranek, Michael Paul Bolognesi, Sean Patrick Ryan, Department of Orthopedic Surgery, Duke University Hospital, Durham, NC 27560, United States
Author contributions: Kim BI was responsible for data collection, data curation, formal analysis, draft writing, draft review and editing; O'Donnell J was responsible for conceptualization, data collection, data curation, draft writing, draft review and editing; Wixted CM was responsible for data collection, draft review and editing; Seyler TM was responsible for supervision, methodology, draft review and editing; Bolognesi MP was responsible for supervision, methodology, draft review and editing; Jiranek WA was responsible for supervision, methodology, draft review and editing; Ryan SP was responsible for supervision, conceptualization, methodology, resources, draft review and editing.
Institutional review board statement: Institutional Review Board (IRB) approval was obtained prior to conducting this study.
Informed consent statement: Verbal patient consent for phone interview participation in the study was obtained.
Conflict-of-interest statement: The authors report no conflicts of interest related to this study.
Data sharing statement: Please contact the corresponding author for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sean Patrick Ryan, MD, Assistant Professor, Department of Orthopedic Surgery, Duke University Hospital, 5601 Arringdon Park Dr. Suite 300, Durham, NC 27560, United States. sean.p.ryan@duke.edu
Received: March 1, 2024 Revised: May 8, 2024 Accepted: May 27, 2024 Published online: July 18, 2024 Processing time: 132 Days and 9.6 Hours
Abstract
BACKGROUND
Tobacco use is a well-documented modifiable risk factor for perioperative complications.
AIM
To determine the tobacco abstinence rates of patients who made cessation efforts prior to a total joint arthroplasty (TJA) procedure.
METHODS
A retrospective evaluation was performed on 88 self-reported tobacco users who underwent TJA between 2014-2022 and had tobacco cessation dates within 3 mo of surgery. Eligible patients were contacted via phone survey to understand their tobacco use pattern, and patient reported outcomes. A total of 37 TJA patients participated.
RESULTS
Our cohort was on average 61-years-old, 60% (n = 22) women, with an average body mass index of 30 kg/m2. The average follow-up time was 2.9 ± 1.9 years. A total of 73.0% (n = 27) of patients endorsed complete abstinence from tobacco use prior to surgery. Various cessation methods were used perioperatively including prescription therapy (13.5%), over the counter nicotine replacement (18.9%), cessation programs (5.4%). At final follow up, 43.2% (n = 16) of prior tobacco smokers reported complete abstinence. Patients who were able to maintain cessation postoperatively had improved Patient-Reported Outcomes Measurement Information System (PROMIS)-10 mental health scores (49 vs 58; P = 0.01), and hip dysfunction and osteoarthritis outcome score for joint replacement (HOOS. JR) scores (63 vs 82; P = 0.02). No patients in this cohort had a prosthetic joint infection or required revision surgery.
CONCLUSION
We report a tobacco cessation rate of 43.2% in patients undergoing elective TJA nearly 3 years postoperatively. Patients undergoing TJA who were able to remain abstinent had improved PROMIS-10 mental health scores and HOOS. JR scores. The perioperative period provides clinicians a unique opportunity to assist active tobacco smokers with cessation efforts and improve postoperative outcomes.
Core Tip: From a retrospective review of 37 self-reported tobacco users undergoing total joint arthroplasty, we found a tobacco cessation rate of 43.2% at nearly 3 years postoperatively. These patients had improved Patient-Reported Outcomes Measurement Information System-10 mental health scores and hip dysfunction and osteoarthritis outcome score for joint replacement scores.
