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Vaping and Orthopaedic Surgery

A Review of Current Knowledge

Amaro, Emilie J., MD1; Shepard, Nicholas, MD2; Moss, Lewis, MD2; Karamitopoulos, Mara, MD2; Lajam, Claudette, MD2

doi: 10.2106/JBJS.RVW.18.00015
Review Articles

  • * Smoking cessation improves surgical outcomes in orthopaedic patients.
  • * Electronic cigarettes (ECs) have been studied as a smoking-cessation tool but are now being used by previous nonsmokers.
  • * ECs may diminish the hazards of conventional tobacco use and serve as a nicotine-delivery device.
  • * EC vapor is associated with cytotoxicity, pro-inflammatory effects, and decreased microbial defense, which may increase perioperative risk for patients undergoing surgery.
  • * EC use in the adolescent population is growing and may pose unique health hazards and operative concerns in an at-risk population.
  • * EC use is difficult to study clinically as most electronic health records do not capture use and because many products with different ingredients exist.
  • * Future clinical trials are needed to evaluate the perioperative risks of ECs.

1Vanderbilt University Department of Orthopedics, Nashville, TN

2NYU Langone Orthopedic Hospital, New York, NY

E-mail address for C. Lajam:

Investigation performed at NYU Langone Orthopedic Hospital, New York, NY

Disclosure: No external funds were received in support of this study. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (

Copyright © 2019 by The Journal of Bone and Joint Surgery, Incorporated
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