Heavy Drinking Increases Complication Risks After Joint Replacement

Jill Stein

February 15, 2011

February 15, 2011 (San Diego, California) — Patients slated for a total joint arthroplasty (TJA) boost their risk for postsurgical complications if they misuse alcohol before their procedure, investigators reported here at the American Academy of Orthopaedic Surgeons 2011 Annual Meeting.

The data also show a link between the frequency of complications and the amount of alcohol consumption.

Nicholas John Giori, MD, associate professor of orthopaedic surgery at Stanford University Hospital in Palo Alto, California, and colleagues examined the association between the number of surgical complications and preoperative scores on the Alcohol Use Disorders Identification Test (AUDIT-C) in 185 TJA patients.

AUDIT-C scores were obtained for all study patients in the 12 months before their surgery, and all reported at least some alcohol use.

AUDIT-C is an alcohol misuse screen that identifies patients who are hazardous drinkers or have active alcohol use disorders, including alcohol abuse and dependence. The test, which is performed annually at Veterans Affairs facilities, consists of the following 3 questions.

  • How often did you have a drink containing alcohol in the last year?

  • How many drinks did you have on a particular day when you were drinking in the past year?

  • How often did you have 6 or more drinks on one occasion when you were drinking in the past year?

Patients at risk for "alcohol misuse" were those who drank alcohol more than 4 times a week, who had more than 9 standard drinks in a typical day, or who routinely had more than 6 drinks a day.

Results showed that 17% of patients had AUDIT-C scores of 4 or more on a scale of 0 to 12, which is indicative of alcohol misuse. Each additional AUDIT-C point produced a 29% increase in the anticipated mean number of complications.

Dr. Giori, who is also an orthopaedic surgeon at the Palo Alto Veterans Affairs Medical Center, said that the findings suggest that it may be helpful to preoperatively screen [total knee arthroplasty] candidates for alcohol misuse and to implement interventions, when indicated.

The researchers have disclosed no relevant financial relationships.

American Academy of Orthopaedic Surgeons (AAOS) 2011 Annual Meeting: Abstract P040. Presented February 15, 2011.