A study published in the January issue of the Journal of Shoulder and Elbow Surgery suggests that smoking may be a significant risk factor of complications after primary anatomic total shoulder arthroplasty (TSA) and reverse shoulder arthroplasty (RSA).

The research team conducted a retrospective case-control study of prospectively collected data on 1,834 shoulders in 1,614 patients (814 smokers and 1,020 nonsmokers). At minimum 2-year follow-up, they found complications in 73 patients: 20 periprosthetic infections (16 in the smoking cohort and 4 nonsmoking), 27 periprosthetic fractures (14 smoking and 13 nonsmoking), and 28 loosenings (14 smoking and 14 nonsmoking). Overall, smokers had reduced periprosthetic infection-free survival rates and lower overall complication-free survival rates compared to nonsmokers. In addition, both current and former smokers were at significantly increased risk of periprosthetic infection in comparison with nonsmokers, and current smokers displayed a higher risk of postoperative fracture than both former smokers and nonsmokers. Learn more...