October 06, 2025
1 min read
Key takeaways:
- Smoking increased the risk for bleeding, readmission and adverse discharge after total ankle arthroplasty.
- Active smoking status was also associated with more than a $400 increase in total admission cost.
Preoperative smoking may increase the risk for bleeding, readmission, adverse discharge and high health care costs after total ankle arthroplasty, according to data presented at the American Orthopaedic Foot & Ankle Society Annual Meeting.
“It just gives us further fodder of counseling people on the preoperative risks of any type of orthopedic surgery that we do,” Christopher E. Gross, MD, professor of orthopedic surgery at the Medical University of South Carolina, told Healio.
Data were derived from Gross CE, et al. The effect of preoperative smoking status on outcomes following total ankle arthroplasty. Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting; Sept. 10-13, 2025; Savannah, Ga.
According to the abstract, Gross and colleagues gathered data from 29,705 patients (54.2% men; mean age, 65.14 years) undergoing primary elective total ankle arthroplasty from 2016 to 2020 from the National Readmission Database.
Christopher E. Gross
Patients were categorized into two groups based on preoperative smoking status.
Outcomes measured included demographics, comorbidities, postoperative outcomes, cost of admission and total length of stay.
Gross and colleagues found preoperative smoking was associated with an increased risk for intraoperative or postoperative bleeding (OR = 5.309; P = .001), readmission (OR = 1.149; P = .002) and adverse discharge (OR = 1.067; P = .039) vs. those who did not smoke prior to primary elective total ankle arthroplasty.
In addition, they found active smoking status was also associated with more than a $400 increase in total cost of admission (P = .029).
However, active smoking status was associated with a decreased risk for sepsis (OR = 0.163; P = .006) and acute renal failure (OR = 0.451; P < .001).
“We need to be better about providing support for our patients who do explore these options of elective surgery, total ankles and fusions to stop smoking and get them on the right track to get them to quit,” Gross said.
For more information:
Christopher E. Gross, MD, can be contacted at cgross144@gmail.com.
Sources/Disclosures
Source:
Gross CE, et al. The effect of preoperative smoking status on outcomes following total ankle arthroplasty. Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting; Sept. 10-13, 2025; Savannah, Ga.
Disclosures:
Gross reports no relevant financial disclosures.
