Smokers prone to complications after orthopedic surgeries

Smokers prone to complications after orthopedic surgeries

Quitting smoking before knee or hip replacement surgeries can be significantly beneficial and improve outcomes

New Delhi, June 13, 2017: The ill-effects of both active and passive smoking have been well-documented and well-known till now. According to study titled ‘Global Burden of Disease’ published in the international journal The Lancet in 2015, more than 1 in 10 deaths globally was caused due to smoking, and over 50% of them took place only in just four countries, one of these being India. Smoking today remains the second largest risk factor worldwide for early death and disability, and contributes significantly to hypertension, cardiovascular ailments, asthma, respiratory diseases, and several types of cancer. But now, there are even more reasons to worry with smoking, and one more prospective rationale to quit, and now!

In a notable clinical finding that might come to many as a surprise, doctors at Indian Spinal Injuries Centre, Vasant Kunj are saying that smokers are more prone to complications after orthopedic surgeries (especially knee or hip replacement or reconstruction surgeries).

“Almost every tissue in the human body can get affected by smoking, including the ones that make up the human musculoskeletal system, and it is a much-known fact that smoking adversely impacts healthy functioning of human body organs. By quitting smoking, one can reduce risk for many medical conditions. Off late, several interesting peer-reviewed research have been conducted in foreign countries which show that smokers are more susceptible to long-term bone and joint problems such as osteoporosis. On the other hand, what is probably more alarming is the fact that people who smoke tend to have a slower recovery period after undergoing an ortho surgery,” says Dr  Vivek Mahajan, Consultant Joint replacement surgeonIndian Spinal Injuries Centre.


Most joint arthroplasty procedures have several post-operative complications associated. Coupled with other co-morbidities such as diabetes, alcohol consumption, and unhealthy lifestyle factors, smoking can cause serious type of complications, including pulmonary health issues, surgical site infections, and make post-operative wounds even more dangerous in nature, say experts.

According to a recent study conducted by New York University’s Langone Medical Center, people who had quit smoking before undergoing a joint replacement surgery experienced better surgical outcomes and were less likely to visit for follow-up surgeries. Those who had managed to quit smoking before the surgery not only had visibly better outcomes, but were also less likely to experience post-surgery issues such as surgical site blood clots, pneumonia, stroke, and urinary tract infections, reveals the study. Another study by American Academy of Orthopedic Surgeons shows that elderly smokers are 30% to 40% more likely to break their hips as compared to their non-smoking counterparts. Notably, smoking could not only make your bone and joints weaker, but also impede the surgical recovery procedure (in terms of internal and interventional methods), and also increases predisposition to critical problems such as rheumatoid arthritis.

“Since smoking impairs lung function in individuals, there remains less oxygen available for muscles among smokers. It also interferes with the calcium absorption in the body and slows down the production of bone-forming cells. No wonder why persons who smoke regularly prior to surgery normally witness a prolonged healing time and a greater risk of complications afterwards. Clinical evidence suggests that nicotine-related products sometimes signal the brain to prevent our bodies from getting adequate amount of nutrition. Over time, smoking will put you at risk for serious bone and joint fractures. On the flipside, if you are able to get rid of this habit before a knee or hip replacement surgery or rotator cuff surgery, the odds for better outcomes may increase significantly and mobility restoration and pain reduction process can also become much easier. All these factors imply why smoking status should be on a top-of-the-mind priority for both orthopedic surgeons and their patients,” says Dr Vivek Mahajan

Switching to a balanced diet rich in antioxidants and anti-inflammatory proteins and minerals and moderate exercising (at least 20 minutes per day) is recommended by doctors at Indian Spinal Injuries Centre, New Delhi, before a patient undergoes total or partial joint replacement or reconstruction surgeries. In fact, if your doctor has even hinted the need for an orthopedic surgery in future, it would be wise to quit in advance.


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