Tobacco use may be associated with increased revision and complication rates following total hip arthroplasty.

The purpose of this study was to compare the clinical outcomes of total hip arthroplasty in patients who were smokers to patients who were non-smokers. All total hip arthroplasties performed between 2007 and 2009 were reviewed to identify patients who indicated tobacco use. There were 110 smokers who were matched in a 1:2 ratio to 220 non-smoking patients. At a mean follow-up of 51 months (range, 24 to 72 months), smokers had an overall significantly lower survivorship of 92% (n = 9 revisions), compared to 99% (n = 2 revisions) in non-smokers. In addition, there were five complications in smokers (one pneumonia, three superficial infections, and one deep peroneal nerve palsy) compared to none in non-smokers. These results indicate that patients who smoke had higher overall revisions and postoperative complications.