No job name

The Musculoskeletal Effects ofPerioperative Smoking Although the carcinogenic consequences of smoking are wellknown, further research is needed on the effects of smoking on musculoskeletal health and surgical outcomes. Orthopaedic perioperative complications of smoking include impaired healing, increased infection, delayed and/or impaired fracture union andarthrodesis, and inferior arthroplasty outcomes. The incorporationof smoking cessation protocols such as transdermal patches,chewing gum, lozenges, inhalers, sprays, bupropion, andvarenicline in the perioperative period may result in substantialbenefits for patients’ musculoskeletal and general health.
More than 10 million cigarettes increased risk of stroke.3 Smoking- the United States, including medicalcosts and lost productivity attribut- Cellular Effects of
owns stock in a commercialcompany or institution related tantly, because it is critical to the de- ery of lymphocytes to infected areas.
The Musculoskeletal Effects of Perioperative Smoking and 20.3%, respectively; P = 0.005) 0.8%, respectively; P < 0.001). Mul- of the patients were active smokers.
union (P = 0.01), twice as likely to (P = 0.05), and 3.7 times more likely to develop chronic osteomyelitis (P = Clinical Impact of
Smoking Cessation
Journal of the American Academy of Orthopaedic Surgeons Nicotine Replacement Therapies: Advantages and Disadvantages
of nicotine addiction.33 The five NRTagents—transdermal patch, chewing Advantages
Disadvantages
and is left in place for 16 to 24 hoursper day. It should not be applied tothe same anatomic area more thanonce per week. Nicotine gum is of- appears to elicit greater success than do equivalent to that of one cigarette.
Orthopaedic Benefits of
Smoking Cessation
The Musculoskeletal Effects of Perioperative Smoking and 20%, respectively; P = 0.048).
References
Evidence-based Medicine: Levels of smokers (P = 0.0003). The difference contents. In this article, reference 43 is References printed in bold type are
those published within the past 5 years.
1. World Health Organization: Smoking Statistics: Fact Sheet. 27 May 2002.
Available at: http://www.wpro.who.int/mediacentre/factsheets/fs_20020528/en/ 2. American Cancer Society: Tobacco- related Cancers Fact Sheet. Available at: http://www.cancer.org/cancer/cancercauses/tobaccocancer/tobacco- Office on Smoking and Health: TheHealth Consequences of Smoking: A Report of the Surgeon General. Atlanta, 4. Sørensen LT, Jørgensen S, Petersen LJ,
et al: Acute effects of nicotine and
smoking on blood flow, tissue oxygen,
and aerobe metabolism of the skin and
subcutis. J Surg Res 2009;152(2):224-
230.
5. Padmavathi P, Reddy VD, Maturu P,
Varadacharyulu N: Smoking-induced
alterations in platelet membrane fluidity
and Na(+)/K(+)-ATPase activity in
chronic cigarette smokers. J Atheroscler
Thromb 2010;17(6):619-627.
6. Feng Y, Kong Y, Barnes PF, et al:
Exposure to cigarette smoke inhibits the
pulmonary T-cell response to influenza
virus and Mycobacterium tuberculosis.
Infect Immun 2011;79(1):229-237.
7. Hoogduijn MJ, Cheng A, Genever PG:
Functional nicotinic and muscarinic
receptors on mesenchymal stem cells.
Stem Cells Dev 2009;18(1):103-112.
8. Rothem DE, Rothem L, Soudry M,
Dahan A, Eliakim R: Nicotine modulates
bone metabolism-associated gene
expression in osteoblast cells. J Bone
Miner Metab 2009;27(5):555-561.
9. Rothem DE, Rothem L, Dahan A,
Eliakim R, Soudry M: Nicotinic
modulation of gene expression in
Journal of the American Academy of Orthopaedic Surgeons osteoblast cells, MG-63. Bone 2011;
lumbar spinal fusion. Spine (Phila Pa 35. Knight C, Howard P, Baker CL, Marton
48(4):903-909.
JP: The cost-effectiveness of an extended
course (12+12 weeks) of varenicline
10. Jorgensen LN, Kallehave F, Christensen compared with other available smoking
cessation strategies in the United States:
production in smokers. Surgery 1998; assessment of nonunion risk factors.
An extension and update to the
Foot Ankle Int 1999;20(8):491-496.
BENESCO model. Value Health 2010;
13(2):209-214.
11. Mueck AO, Seeger H: Smoking, estradiol 36. Silagy C, Lancaster T, Stead L, Mant D, hindfoot fusions. Foot Ankle Int 2002; Hematol Agents 2005;3(1):45-54.
Database Syst Rev 2004;(3):CD000146.
12. Jenkins MR, Denison AV: Smoking
status as a predictor of hip fracture risk
in postmenopausal women of northwest
Antidepressants for smoking cessation.
arthrodesis. Foot Ankle Int 1994;15(2): Texas. Prev Chronic Dis 2008;5(1):A09.
Cochrane Database Syst Rev 2007;(1): 38. Cahill K, Stead LF, Lancaster T:
Nicotine receptor partial agonists for
3617 cases. Injury 2006;37(2):152-156.
smoking cessation. Cochrane Database
arthroplasty? A preliminary retrospective 14. Nåsell H, Ottosson C, Törnqvist H,
Syst Rev 2008;(3):CD006103.
case series. Iowa Orthop J 2005;25:17- Lindé J, Ponzer S: The impact of
39. Shah SD, Wilken LA, Winkler SR, Lin
smoking on complications after
SJ: Systematic review and meta-analysis
operatively treated ankle fractures: A
of combination therapy for smoking
follow-up study of 906 patients.
cessation. J Am Pharm Assoc (2003)
J Orthop Trauma 2011;25(12):748-755.
graphics, and the effect of smoking. Clin 2008;48(5):659-665.
Orthop Relat Res 2002;(404):275-283.
28. Baumgarten KM, Gerlach D, Galatz LM,
Varenicline (Marketed as Chantix) and et al: Cigarette smoking increases the
risk for rotator cuff tears. Clin Orthop
Wellbutrin, and Generics). Silver Spring, Relat Res 2010;468(6):1534-1541.
MD, US Food and Drug Administration.
J Orthop Trauma 2005;19(3):151-157.
29. Karim A, Pandit H, Murray J, Wandless Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/ ligament. J Bone Joint Surg Br 2006; bone. Int Orthop 2007;31(4):503-505.
30. Jaiswal PK, Macmull S, Bentley G,
Woolley J, Burge P: Failure of surgery for Carrington RW, Skinner JA, Briggs TW:
Does smoking influence outcome after
smoking. J Hand Surg Br 2006;31(3): autologous chondrocyte implantation? A
trial. Lancet 2002;359(9301):114-117.
case-controlled study. J Bone Joint Surg
Br 2009;91(12):1575-1578.
42. Villebro NM, Pedersen T, Møller AM,
Tønnesen H: Long-term effects of a
31. Stead LF, Bergson G, Lancaster T:
preoperative smoking cessation
fractures. Injury 2001;32(1):61-65.
Physician advice for smoking cessation.
Cochrane Database Syst Rev 2008;(2):
programme. Clin Respir J 2008;2(3):
19. W-Dahl A, Toksvig-Larsen S: Cigarette CD000165.
175-182.
43. Nåsell H, Adami J, Samnegård E,
32. Rice VH, Stead LF: Nursing
Tønnesen H, Ponzer S: Effect of smoking
interventions for smoking cessation.
cessation intervention on results of acute
technique. Acta Orthop Scand 2004; Cochrane Database Syst Rev 2008;(1):
fracture surgery: A randomized
CD001188.
controlled trial. J Bone Joint Surg Am
33. US Food and Drug Administration: FDA 2010;92(6):1335-1342.
101: Smoking Cessation Products. Silver 44. Hejblum G, Atsou K, Dautzenberg B,
Chouaid C: Cost-benefit analysis of a
(Belle Mead NJ) 2001;30(6):486-489.
Administration. Available at: http://www.fda.gov/forconsumers/ simulated institution-based preoperative
smoking cessation intervention in
patients undergoing total hip and knee
arthroplasties in France. Chest 2009;
cessation on spinal fusion. Spine (Phila 34. Coleman T, Chamberlain C, Cooper S,
135(2):477-483.
Pa 1976) 2000;25(20):2608-2615.
Leonardi-Bee J: Efficacy and safety of
nicotine replacement therapy for
22. Andersen T, Christensen FB, Laursen M, smoking cessation in pregnancy:
Systematic review and meta-analysis.
Addiction 2011;106(1):52-61.

Source: http://www.justinroe.com.au/resources/ArgintarJAAOS2012.pdf