Aseptic Loosening after THA and TKA - Do gender, tobacco use and BMI have an impact on implant survival time?

Purpose: Aseptic loosening (AL) has been reported to be one of the most frequent complications in Total Knee Arthroplasty (TKA) and Total Hip Arthroplasty (THA). The aim of this study was to identify the effects of gender, current tobacco use and BMI on the incidence of AL and implant survival time in THA and TKA.

Methods: Between July 2012 and December 2016 all patients that were diagnosed with an AL of a primary THA or primary TKA and underwent revision surgery at a single institution were retrospectively reviewed for this study. For each patient gender, current tobacco use, BMI, and implant survival time were obtained from the medical records.

Results: 202 patients with 85 THA and 117 TKA were included in this study. There was no impact of the gender on implant survival times (p > 0.05) in THA and TKA. In the TKA group current tobacco use was associated with a significant shorter implant survival time (p < 0.05). For THA and TKA with cemented stem fixation a significant increase of AL was seen in overweight compared to normal weight patients (p < 0.05) and in obese compared to normal weight patients (p < 0.05).

Conclusion: The results demonstrate that current tobacco use and elevated BMI are associated with increased rates of AL in TKA. Also, in THA with cemented stem fixation an elevated BMI is associated with an increased incidence of AL.