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SMOKING/NICOTINE AND JOINT REPLACEMENT SURGERY

If you are planning surgery and smoke or use nicotine products, consider the benefits of quitting.

August 7, 2022

WHAT ARE MODIFIABLE RISK FACTORS?

 

Joint replacement can be life-changing surgery for painful hip and knee arthritis.  It is elective surgery (meaning it can be scheduled in the future and is usually not urgent), but it is still major surgery, and with surgery comes risks.  Every patient has a different risk profile due to different medical conditions and overall health.  Before surgery, surgeons classify each patient’s risk factors for complication into two categories:  modifiable (things we can potentially change or improve before surgery) and non-modifiable (things that we cannot change before surgery).

SMOKING AND SURGERY DON'T MIX WELL

Smoking/nicotine use is a clear modifiable risk factor for complications with any surgery.   Nicotine and the thousands of other chemicals in tobacco products significantly increase the risks of surgery.  Nicotine and chemicals in tobacco decrease the ability of red blood cells to deliver oxygen to tissues and cause blood vessels to constrict.   The chemicals negatively affect your skin, hearing, mouth, heart, lungs, hormones, immune system, muscles, and bones.  They can even affect your DNA, which is why they increase the risk of cancer. 

 

Hundreds of studies on patients having surgery have confirmed higher risks for patients that smoke or use nicotine.  Many joint replacement centers will no longer perform elective joint replacement on patients that use nicotine products because of these risks, which include:

  • Problems with healing of the surgical incision

  • More difficulty controlling pain

  • Higher infection rates and higher reoperation rates for infection

  • Bone healing problems

  • Longer hospital stays

  • Problems with anesthesia

  • Higher risk of pneumonia, blood clots, and urinary tract infections

GET THE BEST RESULT:  USE SURGERY AS YOUR REASON TO QUIT FOREVER

If you are a smoker or use nicotine products, you know that stopping is difficult, but just like joint replacement surgery, it can be life-changing.  If you have arthritis and are considering joint replacement, this may be your opportunity to finally quit.  We strongly recommend that all nicotine products are discontinued at least 1 month prior to your surgery date, and indefinitely after surgery.  Some surgeons verify that patients have stopped with laboratory analysis to determine nicotine and other metabolite levels in the body.  Please talk with your primary care provider and visit the links below to learn about resources to help you stop smoking and using any other nicotine products.

 

SmokeFree.gov

 

www.uchealth.org/services/respiratory-lung-care/smoking-cessation

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