title: Effect of Smoking on Joint Replacement Outcomes: Opportunities for Improvement Through Preoperative Smoking Cessation.
abstract: Because orthopaedic surgeons focus on identifying serious potential complications, such as heart attack, stroke, and deep vein thrombosis, during the preoperative assessment, correctable factors, such as smoking, may be overlooked. Chronic exposure to nicotine has been correlated with perioperative complications that lead to worse outcomes, including decreased patient satisfaction, longer hospitalization periods, and an increased rate of hospital readmission. It has been proven that smoking is a negative risk factor for decreased bone mineral density, which leads to increased fracture risk, heightened pain, postoperative wound and bone healing complications, decreased fusion rates, and postoperative tendon and ligament healing complications. Physician-led preoperative smoking cessation programs that include, but are not limited to, pharmacotherapy plans have been shown to improve primary surgical outcomes and smoking cessation rates. Smoking has detrimental effects on specialty-specific physiology; however, there are many effective options for intervention that can improve primary outcomes.
authors.affiliation: Medical Student, Department of Orthopedics, Southern Illinois School of Medicine, Springfield, Illinois.
authors.forename: Erik
authors.initials: E
authors.lastname: Wright
authors.forename: Tony H
authors.initials: TH
authors.lastname: Tzeng
authors.forename: Michael
authors.initials: M
authors.lastname: Ginnetti
authors.forename: Mouhanad M
authors.initials: MM
authors.lastname: El-Othmani
authors.forename: Jamal K
authors.initials: JK
authors.lastname: Saleh
authors.forename: Jasmine
authors.initials: J
authors.lastname: Saleh
authors.forename: J M
authors.initials: JM
authors.lastname: Lane
authors.forename: William M
authors.initials: WM
authors.lastname: Mihalko
authors.forename: Khaled J
authors.initials: KJ
authors.lastname: Saleh
mesh_terms: D019643:Arthroplasty, Replacement / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007592:Joint Diseases / Q000523:psychology / Q000601:surgery; D010347:Patient Care Planning; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000503:physiopathology; D016540:Smoking Cessation / Q000379:methods*; D014945:Wound Healing