Orthopaedic Surgeon
Smoking
Why are tobacco products bad for orthopaedic patients?
Tobacco products are extremely bad for your health. Many patients have heard about smokers risk for conditions like heart disease, lung disease, early aging, and damage to teeth and gums. However, many patients do not realize that smoking also affects your bones and muscles.
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The contents of cigarettes are addicting and harmful to your health. Carbon monoxide reduces tissue oxygenation and impairs the microcirculation within healing soft tissue and bone. Nicotine is also a potent vasoconstrictor and impairs the revascularisation of healing bone leading to impaired bone and wound healing.
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In many articles published in the orthopaedic litterature, smoking is the single most important risk factor for the development of serious postoperative complications in patients undergoing elective hip and knee arthroplasty.
Why is it important to talk about tobacco use?
Smoking cigarettes and using tobacco products can have a terrible affect on your muscle and joint pain.
The decreased blood flow associated with smoking can lead to increased risk of infections and wound complications with surgery.
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The affects on blood flow can also place you at a higher risk for a blood clot which could possibly lead to a pulmonary embolism, heart attack, and/or stroke--all of those conditions can kill you.
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Smoking also influences the ability for bone to heal after a fracture. Similarly, soft tissues like rotator cuff repairs and ACL reconstructions may not heal as well if you are smoking.
How is tobacco addiction treated?
Tobacco is extremely addictive and it is very difficult to stop this habit. Treatments are usually multi-modal attempting to treat the addiction in multiple ways. This involves trying to avoid being around other smokers, developing help groups with a shared interest in smoking cessation, and meeting with your primary care physician to discuss medical treatments to help you stop smoking.
If you can stop smoking prior to surgery and during the period of rehabilitation, it has been shown to significantly reduce post-operative complications and improve the chance of success.
References
1. Castillo RC, Bosse MJ, MacKenzie EJ, Patterson BM, LEAP Study Group. Impact of smoking on fracture healing and risk of complications in limb-threatening open tibia fractures. J Orthop Trauma 2005;19:151-7.
2. Connoly P, dudeney S, McManus F, fitzpatrick JM- the effects of nicotine on osteoblast SaSO2 cell proliferation and cell function in vitro-J Bone Joint Surg Br-81B,supp3,1999:296-297.
3,Kwiatkowski TC, Hanley EN, Ramp WK: cigarettes smoking and its orthopedics consequences : Am J Orthop 1996,25:590-597.