The evidence that preoperative smoking cessation provides decreased postoperative morbidity and complications is continuing to develop and offer stronger results. Although the intensity of the intervention required for a long-term positive impact remains unknown, direct communication between the physician and their patient in combination with nicotine replacement therapy seems to offer the greatest reduction in postoperative morbidity. With many institutions now implementing group classes to prepare patients for their upcoming surgery, adding a smoking cessation group therapy component may further offer patients mutual support to stop smoking before total joint arthroplasty. Preoperative smoking cessation programs not only offer health benefits to the patient by decreasing their risk for periprosthetic joint infection or other complications but also may also lower the cost of care.
Northwell Health, Lenox Hill Hospital, New York, NY
This project was supported by an unrestricted grant from KCI, an Acelity company. Project management support was provided by MedicusWorks.
G.R.S. receives royalties from Zimmer Biomet; he is a consultant for Zimmer Biomet, Acelity, Medtronic, Convatec, and Force Therapeutics; he received research support from Pacira; and book royalties from Springer, Elsevier, Theime, and World Scientific. The remaining authors declare that they have nothing to disclose.
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