According to the CDC, cigarette or tobacco smoking remains the number one cause of preventable illness, disability, and death in the US. In fact, over 16 million Americans currently suffer from a chronic disease as a result of long-term smoking.
Besides causing significant damage to the organs, smoking can also affect the outcome and impede the recovery of patients undergoing surgical procedures. One good example is how smoking can complicate and reduce the success rate of knee replacement surgery.
Learn more about the how’s and why’s as our board-certified orthopedic surgeon Dr. Imad Tarabishy discusses it below.
What is knee replacement surgery? When is it needed?
Knee replacement surgery or knee arthroplasty is a procedure that involves the removal of damaged bone and cartilage surface in the knee joints. It is then replaced by an artificial implant which will be secured in the kneecap through metal screws and rods.
In general, orthopedic surgeons perform this type of surgical procedure to treat defective knee joints that have been causing pain and disability. Your doctor will most likely recommend a knee replacement surgery for severe or chronic cases of the following diseases:
- Knee osteoarthritis and rheumatoid arthritis
- Irreversible knee joint damage caused by fracture, ligament injury, and cartilage tear.
- Tendinitis
- Traumatic injury
A knee replacement surgery can also become an option when conservative methods fail to treat your knee joint pain.
What are the effects of smoking on the outcome of knee replacement surgery?
According to the American Academy of Orthopaedic Surgeons, knee replacement surgery is a safe and effective procedure with a 90% success rate. In fact, it has been reported that 90% of these implants are still functioning after 15 years and 82% after 25 years.
Additionally, patients undergoing the procedure rarely encounter any complications and problems. But the same cannot be said for avid cigarette and tobacco smokers. Here’s why:
- Smoking damages the bones and circulatory system
Knee arthroplasty involves creating an incision through the skin and muscles to access the impaired knee joint. It also includes cutting away damaged bone and cartilage to make way for the new prosthetic joint.
Since this invasive procedure will cause physical trauma, the body will need all of its inner systems to work double-time for faster recovery. For example, the operated knee will require a significant amount of blood supply to the bone, and muscles can heal properly. The bones also need a lot of bone-forming cells (osteoblasts), so they can recover from the trauma and remain healthy.
Unfortunately, smoking hinders all of these healing mechanisms. It has a detrimental effect on the production of osteoblasts and oxygenation of the red blood cells due to the nicotine and carbon monoxide.
- It increases the chance of wound complications and infections during surgery
According to the WHO, tobacco smokers are at a higher risk of developing post-surgical complications, such as infection and delayed wound healing.
These complications are more likely to affect smokers since the harmful chemicals inside cigarettes and tobacco weaken the body’s immune system. Furthermore, nicotine and carbon monoxide impairs the circulatory system by delaying the delivery of oxygen and nutrients necessary for the body’s healing.
As we know, the longer it takes for the body to heal, the more likely it is for the wound to catch an infection, which the body may not be able to get rid of.
- It increases the likelihood of heart attack and pneumonia during and after the operation
Smoking is harmful to nearly every organ in the body. But it has a particularly negative effect upon the heart and lungs, hence the increased risk for heart and lung disease for smokers.
So if you’re a smoker, then there’s a big chance that your heart and lungs do not function as well as they should. You may already have an underlying heart or lung illness that may worsen during the operation. Some of the possible scenarios that may occur during the procedure which can endanger your life include:
- Sudden heart attack
- Breathing problems include hypoventilation, hypoxemia, and pulmonary edema
- Pneumonia
- Bronchospasm
These conditions may also present themselves after the operation, which increases the chance of death for chronic smokers.
- It increases the chance of implant revision
The biggest fear of doctors and patients undergoing knee replacement is the need for a revision procedure. An implant revision may be needed when the prosthetic knee joint fails to reduce pain and immobility. The procedure is also required when the surrounding structures fail to heal or develop an infection.
In general, knee arthroplasty has a 90% success rate and can last for a lifetime. However, the chance for an implant revision increases due to certain factors, such as smoking.
- It significantly delays recovery and healing
With hundreds of harmful chemicals inside, it’s no surprise that cigarette and tobacco smoking contribute to diseases and fatal conditions. As a result, these ailments can then impede body healing and prolong recovery, exposing the patient to several health complications.
Even after a successful knee replacement surgery, smokers can still fall prey to other degenerative conditions, such as hip fractures and osteoporosis.

Get the Highest Quality of Knee Replacement Surgery in the Spring Hill Area, FL
Reap the full benefits of knee arthroplasty by quitting smoking and other harmful vices. You can also ensure your operation’s success by choosing one of the best orthopedic doctors in Brooksville, FL, Dr. Tarabishy.
Dr. Imad E. Tarabishy is a fellow at the American Academy of Orthopaedic Surgeons, specializing in treating various musculoskeletal conditions.
He has been providing his services in Florida for more than 30 years, using advanced medical techniques in a state-of-the-art facility. Dr. Tarabishy performs a wide array of orthopedic procedures, such as:
And many more!
Contact us now to book an appointment and start enjoying life again, free from any pain and discomfort.
The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.