Smoking and Knee Surgery: What You Need to Know

If you're considering knee surgery, whether it's a knee replacement, ligament repair, or another procedure, you might be wondering how smoking could impact your recovery process. Smoking is well-known for its negative effects on the body, particularly in relation to healing and recovery. It can complicate surgeries of all kinds, including those involving the knees, by slowing down the healing process and increasing the risk of complications. Understanding how smoking can affect your knee surgery outcome is crucial in making informed decisions about your health. Let’s take a closer look at the most common questions people have about smoking and knee surgery to help you better navigate your recovery journey.

Smoking and Knee Surgery Recovery

Should You Stop Smoking Before Knee Surgery?

Yes, you should ideally stop smoking well before your knee surgery. Smoking can slow down your body’s ability to heal after surgery, increase the risk of complications, and affect anesthesia. Smoking reduces blood flow, meaning oxygen and nutrients that are needed for recovery are less likely to reach the surgical site. For the best chance at a smooth recovery, it’s recommended that you stop smoking at least 4 to 6 weeks before surgery. (sorry)

Can You Smoke Before Knee Surgery?

While it’s always better to quit smoking well before your knee surgery, smoking right before the procedure is strongly discouraged. Smoking has been shown to significantly increase the risk of several serious complications during and after surgery, making it essential to understand the risks associated with smoking in the days leading up to the procedure.

Increased Risk of Infections

One of the most significant risks of smoking before knee surgery is the increased likelihood of infections. Smoking impairs the immune system, making it less effective at fighting off bacteria that could enter the body during the surgical process. Wounds take longer to heal, and the surgical site is more vulnerable to infection. Infections can delay recovery and may even require additional procedures to treat, complicating the healing process and extending the time needed to fully recover.

Poor Wound Healing

Smoking also interferes with blood flow, which is critical for healing after surgery. Nicotine and other chemicals found in cigarettes constrict blood vessels, reducing oxygen and nutrient delivery to the tissues, which can slow down the healing process. For knee surgery, where mobility and weight-bearing ability are crucial, slower healing can prolong recovery, increase pain, and reduce the overall success of the surgery.

Increased Risk of Blood Clots

Smoking significantly increases the risk of developing blood clots, which are a common complication after surgery. The chemicals in cigarette smoke can cause changes in blood clotting factors, making the blood more likely to clot. Blood clots can be dangerous if they travel to the lungs (pulmonary embolism) or other parts of the body, potentially leading to life-threatening situations. The risk of clots is higher in individuals who are immobile after surgery, and smoking can compound this problem.

Respiratory Issues During Anesthesia

Smoking also has negative effects on the respiratory system, which can lead to complications during anesthesia. Anesthesia medications can affect breathing, and smokers are more likely to have compromised lung function or chronic respiratory conditions like chronic obstructive pulmonary disease (COPD). This can make it more difficult for the body to handle anesthesia, increasing the risk of breathing problems during and after surgery. Proper lung function is essential for safe anesthesia administration and recovery.

Impact on Fasting Before Surgery

Many surgeries, including knee surgery, require patients to fast for a period before the procedure. This typically includes not eating or drinking for a specific time to prevent complications during anesthesia. Smoking can interfere with the fasting process, as it can stimulate the production of stomach acid, potentially increasing the risk of acid reflux or aspiration during surgery. It’s important to follow the fasting instructions provided by your surgeon to reduce these risks.

The Importance of Being Honest with Your Doctor

If you smoke, it is crucial to be honest with your doctor about your smoking habits. Your healthcare team needs to understand your smoking history in order to assess the risks and plan the best course of action for your surgery. They can provide specific advice on when to stop smoking before surgery, how to manage withdrawal symptoms, and whether you might benefit from smoking cessation programs or nicotine replacement therapies. Stopping smoking even a few weeks before surgery can significantly improve your chances of a smooth recovery and minimize the risks associated with surgery.

What Can You Do to Quit Smoking Before Knee Surgery?

• Nicotine Replacement: Patches, gum, and lozenges can help you gradually reduce nicotine dependence.

• Medication: Some medications, like varenicline (Chantix) or bupropion (Zyban), can help reduce cravings and withdrawal symptoms.

• Support Groups & Counseling: Behavioral therapy and support groups can help you stay committed to quitting.

• Stay Active: Exercise can help reduce cravings and improve circulation, speeding up your healing after surgery.

  
  

If you can’t quit smoking before surgery, don’t be discouraged. Speak with your surgeon about your concerns. While quitting early is ideal, your surgeon can work with you to minimize risks, such as adjusting anesthesia, medications, and post-surgery care.

Conclusion:

Smoking before and after knee surgery is a serious concern and can significantly hinder your recovery process. Quitting smoking well in advance of your procedure, ideally 4 to 6 weeks before surgery, can give you the best chance for a speedy and successful recovery. If you struggle to quit, reach out to your healthcare provider for resources and support. The better you prepare, the more likely your surgery will be successful, and the faster you'll get back on your feet!

Remember to always consult your healthcare professional before starting any new treatment or exercise regimen to ensure it's safe and appropriate for your specific condition. Reference:

1. Orthopaedic and Spine Center. (n.d.). Having a Knee Replacement as a Smoker – What You Need to Know. Retrieved from https://www.osc-ortho.com/blog/having-a-knee-replacement-as-a-smoker-what-you-need-to-know

2. American Association of Hip and Knee Surgeons. (n.d.). It is Important to Stop Smoking Before Knee Replacement. Retrieved from https://hipkneeinfo.org/knee-care/it-is-important-to-stop-smoking-before-knee-replacement

3. U.S. National Library of Medicine. (2014). The Effect of Smoking on Ligament and Cartilage Surgery in the Knee. PubMed Central. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC3978172

4. American Academy of Orthopaedic Surgeons. (n.d.). Orthopaedic Surgery and Smoking. OrthoInfo. Retrieved from https://orthoinfo.aaos.org/en/treatment/surgery-and-smoking

5. Midwest Center for Joint Replacement. (n.d.). How Smoking Impacts Joint Replacement Outcomes. Retrieved from https://www.mcjr.com/smoking-causes-worse-outcomes-in-joint-replacement