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Patients who smoked had higher rates of wound complications after total ankle arthroplasty
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TORONTO — Patients who underwent total ankle arthroplasty and smoked experienced significantly higher rates of wound complications and worse functional outcome scores than nonsmokers, according to results presented at the American Orthopaedic Foot & Ankle Society Annual Meeting.
“Active smokers had a significantly higher rate of wound complications and worse functional outcome scores at 1 year and 2 years,” Alexander J. Lampley, MD, said in his presentation. “They did not have any increased rate of comorbidities that would increase their risk of wound complications, so this is likely explained by their cigarette use.”
Overall, Lampley and colleagues identified 646 patients who had primary total ankle replacement and categorized patients into nonsmoking, active smoking or former smoking groups. Researchers looked at complications and collected SF-36 scores, American Orthopaedic Foot & Ankle (AOFAS) hindfoot scores and Short Musculoskeletal Functional Assessment (SMFA) scores.
Alexander J. Lampley
“[It is] important to know that wound breakdown was defined as any wound healing issue that required a return to the operating room,” Lampley said. “So this did not include delayed wound healing and it did not include any patient with wound breakdown that was treated in the clinic with local wound care.”
Compared with nonsmokers, results showed higher rates of all complications among active smokers. However, Lampley noted wound breakdown was the only complication that was statistically significant (11% vs. 3.9%). Researchers found no statistically significant differences in complications between former smokers and nonsmokers.
“When we look at the active smokers compared to the nonsmokers, we see at 1 year the active smokers had lower functional outcome scores with the SF-36 and SMFA at 1 years and 2 years postoperative[ly],” Lampley said.
He noted no statistically significant differences in outcome scores at 1 year and 2 years between former smokers and nonsmokers. – by Casey Tingle
Reference:
Lampley AJ, et al. Is cigarette use associated with increased complication rates and worse functional outcomes following total ankle arthroplasty? Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting; July 21-23, 2016; Toronto.
Disclosure: Lampley reports no relevant financial disclosures.