Arthroplasty knee surgery and alcohol use: risk factor or benefit?

Clin Orthop Relat Res. 2013 Jan;471(1):189-94. doi: 10.1007/s11999-012-2490-5.

Abstract

Background: Excessive alcohol consumption has been associated with adverse measures of health after elective surgery. However, associations of low/moderate consumption remain uncertain.

Question/purposes: We determined differences among patients with three different self-reported consumption levels in (1) preoperative/postoperative patient-perceived outcomes and knee scores, (2) preoperative/postoperative changes in these scores, (3) preoperative demographics and comorbidities, and (4) length of stay (LOS) and inpatient charges.

Methods: We retrospectively studied 430 patients (545 TKAs). Based on a self-administered consumption questionnaire, patients were stratified into groups: (1) nondrinkers, (2) occasional drinkers, and (3) moderate drinkers. We compared the following variables between groups: demographics, BMI, American Society of Anesthesiologists score, Charlson Comorbidity Index, preoperative and postoperative Quality of Well-being Index (QWB-7), SF-36 score, WOMAC score, Knee Society (KS) Score, Hospital for Special Surgery (HSS) knee score, LOS, and hospital charges. QWB-7, SF-36, WOMAC, KS, and HSS scores were compared adjusting for patient characteristics. Minimum followup was 1 year (average, 3.4 years; range, 1-6 years).

Results: Preoperatively, compared to self-reported nondrinkers, moderate drinkers had better QWB-7, SF-36, and WOMAC scores. At followup, occasional and moderate drinkers had better KS function and HSS scores. However, nondrinkers had greater SF-36 general health improvement. Most nondrinkers were older, female, and Hispanic and had more comorbidities. Nondrinkers had a longer LOS.

Conclusions: Self-reported alcohol consumption was more common among men and non-Hispanics. Moderate drinkers had better preoperative QWB-7, SF-36, and WOMAC scores and shorter LOS than nondrinkers. However, after surgery, self-reported abstainers achieved greater improvements in the SF-36 general health score.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alcohol Drinking / adverse effects*
  • Arthroplasty, Replacement, Knee*
  • Databases, Factual
  • Female
  • Humans
  • Knee Joint / surgery*
  • Length of Stay
  • Male
  • Middle Aged
  • Osteoarthritis, Knee / surgery*
  • Pain Measurement
  • Patient Satisfaction*
  • Prognosis
  • Quality of Life
  • Recovery of Function*
  • Retrospective Studies
  • Risk Factors
  • Self Report
  • Sex Factors
  • Surveys and Questionnaires
  • Treatment Outcome