Smoking is bad for knee ligament and cartilage surgery, too

As if we needed another reason not to smoke, let me offer one anyway.

Smoking harms knee cartilage and ligament surgeries.

Cigarette smoking has been shown to have many medical and orthopaedic consequences.
Despite public awareness campaigns and limits on advertising, the Centers for Disease Control and Prevention reports that approximately 19.3% (or 45.3 million) of American adults smoke. It also reported that an alarming percentage of kids use tobacco. In 2011, 23.2% of high school students and 7.1% of middle school students used some form of tobacco, while 15.8% of high school students and 4.3% of middle school students smoked cigarettes.

Smoking has been linked to a number of chronic medical conditions, including many cancers, cardiovascular disease, diabetes. In addition to the medical risks, cigarette smoking has been shown to negatively impact healing of broken bones, bone mineral density, and wound repair.

Generally, athletes and adults who exercise rarely smoke. Smoking would dramatically affect sports performance and the ability to exercise. If they did smoke and got injured, smoking would hurt them even more.

A new study in the December 2012 issue of The American Journal of Sports Medicine suggests that smoking would adversely affect athletes who undergo ligament or cartilage surgery.

Patellar tendon ACL graftPraveen Kanneganti, MD, et al. performed a review of eight studies of knee ligament surgeries and six of knee cartilage surgeries. From both a basic science standpoint, looking at cellular and anatomic changes, as well as clinical studies of functional outcomes after surgery, the authors showed that cigarette smoking impairs ligament surgeries, like those of the ACL and MCL. Smoking had negative affects on cartilage surgeries as well, although the direct impact was less clear.

The study could not determine the exact mechanism by which smoking causes harm with these procedures. Is the culprit nicotine or other gases in the smoke? Is smokeless tobacco equally harmful?

Regardless, this evidence provides one more reason, in a long list of them, for athletic individuals of all ages to stop smoking. Better yet, don’t start in the first place!

Does this study and its findings surprise you? Are you a former smoker who managed to quit and get healthier? Share your story or thoughts below!

Kanneganti P, Harris JD, Brophy RH, Carey JL, Lattermann C, and Flanigan DC. The Effect of Smoking on Ligament and Cartilage Surgery in the Knee: A Systematic Review. Am J Sports Med. 2012;40:2872-2878.
Centers for Disease Control and Prevention. Vital Signs: Current Cigarette Smoking Among Adults Aged ≥18 Years – United States, 2005–2010. MMWR Morb Mortal Wkly Rep. 2011;60(35):1207-1212.
Centers for Disease Control and Prevention. Current Tobacco Use Among Middle and High School Students — United States, 2011. MMWR Morb Mortal Wkly Rep. 2012;61(31):581-585.

One Response to Smoking is bad for knee ligament and cartilage surgery, too

  1. It’s doesn’t matter what a smoker’s source of nicotine is : cigarettes, pips, patches, e-cigarettes… Nicotine hardens the arteries which cause poor blood circulation.
    We , human beings, have capacity for natural self-healing, but with nicotine in the blood a smoker can’t heal himself or herself, it’s very difficult. Whole organism of a smoker is detuned because of nicotine.
    The conclusion is simple: every smoker who suffers from nicotine should become a non- smoker!

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david-headshot I am an orthopaedic surgeon and sports medicine specialist in Charleston, South Carolina.

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