Nicotine is widely known for its harmful effects on the lungs and heart, but its impact on joint surgery recovery is often underestimated. Patients who smoke or use nicotine products may face slower healing, higher complication rates, and reduced long-term outcomes after procedures like hip and knee replacement. Here’s what patients need to know about nicotine and delayed healing after joint surgery.
How Nicotine Impacts Joint Surgery Recovery
Nicotine restricts blood vessels and reduces oxygen delivery to tissues, a critical factor for healing after surgery. In orthopedic procedures such as hip and knee replacement, proper circulation is essential to repair bone, tendon, and soft tissue. Reduced oxygen and nutrient supply caused by nicotine can impair collagen production and slow tissue regeneration, making recovery longer and more challenging.
Delayed Healing and Surgical Complications from Smoking
Patients who use nicotine before or after surgery face an increased risk of complications. These can include slower wound healing, a higher likelihood of infection, and weaker tendon or bone integration. Studies show that smokers are more likely to experience delayed functional recovery, meaning returning to normal mobility or exercise takes longer. In some cases, complications may even require revision surgery, further prolonging recovery.
Evidence Linking Nicotine to Poor Postoperative Outcomes
Multiple studies have confirmed the negative impact of nicotine on joint surgery recovery. Research indicates that smokers undergoing total hip or knee replacement have significantly higher rates of infection and slower tissue healing compared to non-smokers.1 Even short-term nicotine exposure before surgery can increase complication rates, highlighting the importance of preoperative planning and patient education.
Nicotine and Orthopedic Procedures: Hip and Knee Surgery
Nicotine’s effects are particularly relevant in procedures like total knee replacement and total hip arthroplasty, where bone and soft tissue must integrate with surgical implants. Patients who smoke often report more post-surgery pain, longer rehabilitation, and delayed return to walking or physical therapy. Surgeons frequently recommend nicotine cessation as part of preoperative optimization to maximize surgical success.
Reducing Nicotine Before and After Surgery
For patients preparing for joint surgery, reducing or quitting nicotine use can dramatically improve outcomes. Even temporary cessation a few weeks before surgery can enhance circulation, improve tissue oxygenation, and reduce the risk of infection. Postoperative avoidance of nicotine further supports hip and knee replacement recovery and ensures rehabilitation efforts are more effective. Patients should discuss cessation strategies with their orthopedic surgeon to create a personalized plan.
Enhancing Joint Surgery Recovery with Expert Guidance
Nicotine use can significantly slow recovery and increase complications after joint surgery, but careful planning and lifestyle changes can improve outcomes. If you’re preparing for knee or hip replacement surgery, schedule a consultation with Dr. Ehmke to discuss strategies for optimizing recovery, including nicotine cessation, rehabilitation planning, and individualized surgical care. Taking these steps can help ensure a smoother recovery and a stronger long-term result.
AUTHOR: Dr. Andrew Ehmke is a board-certified and fellowship-trained joint replacement surgeon specializing in robotic-assisted and minimally invasive hip and knee replacement in Chicagoland and NW Indiana.
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