In a study out this month, smokers were at substantially increased risk of all sorts of complications after a knee or hip replacement. Researchers from the University of Alabama at Birmingham assessed the effects of cigarette smoking on 33,336 patients, 30 days after elective total hip or total knee replacement surgery. Smokers who have total knee or hip replacement surgeries are at a significant risk of 30-day postoperative complications and/or death at one year. But what really surprised us were these statistics: 53% greater chance of infection, 161% greater chance of stroke, 63% greater chance of 1-year mortality, 34% greater chance of pneumonia. We’ve blogged many times in the past that hip and knee replacement complications are legion, as these are big surgeries. As examples, consider that metal on metal hip resurfacing implants have been associated with everything from local irritation of the tissues to higher concentrations of toxic metal ions in the blood. Also the fact that pretty much every type of hip or knee replacement implant creates wear particles that end up in the blood stream. Also the fact that some patients have severe knee pain despite getting their knee replaced. We also know that age impacts knee and hip replacement complications, with the odds of perishing from a hip replacement 13 times higher for patients age 80 and over. In addition, heavier patients also do poorly after hip or knee replacement when compared to their lighter counterparts. The upshot? If you’re thinking of a knee or hip replacement, look at other biologic options. If you still want to get your hip or knee replaced and still smoke, consider quitting before pulling the trigger on the surgery.