Pagsususok at Pagpapagaling ng Musculoskeletal Impormasyon

Ano ito

Ang pagsusuka at iba pang paggamit ng tabako ay maaaring magpabagal o mahinain ang kakayahan ng iyong katawan na gumaling pagkatapos ng orthopaedic surgery. Kasama rito ang joint replacements, spine fusions, at tendon repairs. Pinag-aaralan ng iyong doktor ang mga gawi na ito dahil direktang nakakaapekto ito sa iyong paggaling.

Ang nicotine ay nakakaapekto sa paglago ng iyong mga buto at sa kung gaano kagaling ang pagdikit ng mga implant sa iyong balangkas. Binabawasan nito rin ang daloy ng dugo, na kailangan ng mga tendon at kalamnan upang magpagaling. Mas mataas ang panganib kung mas marami kang susuklayin. Ang iyong pack-years at ang tagal ng iyong paghinto sa pagsusuka ay tumutulong na ma-predict kung gaano kagaling ang iyong mga tendon pagkatapos ng shoulder surgery.

Ito ay umiiral sa lahat ng anyo ng tabako. Mas mataas ang panganib ng mga medikal at surgical complications para sa mga cigarette smokers habang nasa proseso ng knee o hip replacement. Ang mga gumagamit ng heated tobacco ay nakakaranas ng katulad na mga problema sa paggaling sa rotator cuff repairs kumpara sa mga cigarette smokers. Ang smokeless tobacco ay nagpapataas din ng panganib ng mga komplikasyon at revision surgery pagkatapos ng knee replacement at ACL reconstruction. Sa ilang mga prosedura, ang smokeless tobacco ay may mas mataas na panganib ng mga komplikasyon kaysa sa pagsusuka lamang.

Itatanong ng iyong doktor tungkol sa lahat ng paggamit ng tabako, kasama ang mga smokeless products, bago ang mga surgery tulad ng scaphoid fracture repair o ACL reconstruction. Tumutulong ito sa maagang pagtukoy ng mga panganib. Lubos na inirerekomenda ang paghinto sa paggamit ng tabako para sa mga meniscus repairs upang bawasan ang mga rate ng pagkabigo. Bagama’t ang mga modernong teknik ay maaaring tumulong sa ilang mga pasyente sa spine fusion, nananatiling pinakamainam na paraan ang paghinto upang mapabuti ang mga resulta at bawasan ang mga gastusin.

Gumagana ba ito?

Ang paggamit ng sigarilyo at tabako ay karaniwang nagpapabagal at nagpapahirap sa paggaling. Tanungin ng iyong doktor ang tungkol sa lahat ng uri ng tabako, kabilang ang sigarilyo, smokeless tobacco, at mga produktong tabakong pinainit. Pinakamainam na huminto bago ang operasyon upang mapabuti ang iyong mga resulta.

Para sa karamihan ng mga joint replacement at spine fusion, pinataas ng paggamit ng sigarilyo ang iyong risk ng mga komplikasyon. Maaari kang harapin ang mas mataas na rate ng impeksyon, mga isyung medikal, at mahinang functional outcomes. Tama ito para sa mga knee at hip replacement, shoulder surgeries, at spinal fusions. Mayroon ding risk ang smokeless tobacco, bagaman may ilang ebidensya na ang paggamit ng sigarilyo ay maaaring magdala ng kaunting mas mataas na risk para sa ilang komplikasyon.

Ang paggaling pagkatapos ng rotator cuff repair ay partikular na sensitibo sa paggamit ng tabako. Mahalaga ang bilang ng taon na iyong nagsigarilyo at kung gaano katagal kang huminto bago ang operasyon. Kahit na huminto ka lamang sa loob ng anim na buwan bago ang operasyon, hindi ganap na tinatanggal ang mataas na risk ng impeksyon o ang pangangailangan para sa revision surgery kumpara sa mga hindi nagsigarilyo. Ang mga heated tobacco products ay nakakaapekto sa paggaling nang katulad ng mga karaniwang sigarilyo.

Hindi pantay-pantay ang ebidensya sa lahat ng mga prosedura. Para sa ilang mga spinal fusion, ang mga modernong teknik ay maaaring makatulong upang maibsan ang negatibong epekto ng paggamit ng sigarilyo. Sa mga partikular na kaso na ito, ang paggamit ng sigarilyo ay hindi nauugnay sa nabigo na fusion sa mga X-ray. Gayunpaman, dapat mong inaasahan ang mas mataas na antas ng sakit at mas mahinang function kung ikaw ay nagsisigarilyo.

Para sa mga knee replacement, ang paggamit ng sigarilyo sa loob ng 30 araw bago ang operasyon ay nagdudulot ng mas malakas na sakit pagkatapos ng operasyon. Mas maliit ang posibilidad na makamit mo ang komportableng antas ng sakit kumpara sa mga dating nagsisigarilyo o mga hindi nagsisigarilyo. Katulad nito, madalas na nag-uulat ng mas mahinang long-term function pagkatapos ng ankle cartilage repair ang mga nagsisigarilyo.

Ang ACL reconstruction ay nagpapakita ng halo-halong larawan. Ang mga nagsisigarilyo ay may parehong rate ng graft failure kumpara sa mga hindi nagsisigarilyo ngunit nag-uulat ng mas mahinang functional outcomes. Ibig sabihin, maaaring mas maramdaman mong hindi matatag o malakas ang iyong tuhod sa mga pang-araw-araw na gawin, kahit na teknikal na matagumpay ang operasyon.

Sa kabuuan, ang paggamit ng sigarilyo ay isang pangunahing salik sa iyong paggaling. Nakakaapekto ito sa sakit, function, at mga rate ng komplikasyon sa maraming orthopaedic na prosedura. Tatalakayin ito ng iyong doktor upang matulungan kang makamit ang pinakamainam na posibleng resulta.

Tama ba ito para sa iyo?

Ang pagsusuka at paggamit ng tabako ay nagpapataas ng iyong panganib ng mga komplikasyon at mas mabagal na paggaling sa maraming mga operasyong ortopediko. Kasama rito ang mga palitan ng kasukasuan tulad ng operasyon sa balikat, tuhod, at balikat, pati na rin ang mga pagkukumpuni para sa mga tear ng rotator cuff, rekonstruksyon ng ACL, at pagsasama ng gulugod. Itatanong ng iyong doktor ang tungkol sa lahat ng anyo ng tabako, kabilang ang smokeless tobacco at mga produktong tabakong pinainit. Ang mga produktong ito ay may katulad na panganib sa karaniwang sigarilyo para sa mahinang paggaling at mas masamang resulta.

Kung ikaw ay kasalukuyang nagpupusot, maaaring harapin mo ang mas mataas na antas ng mga medikal at operasyonal na komplikasyon. Maaari kang maranasan ang mas maraming natitirang sakit at mas mahinang pag-andar pagkatapos ng ilang mga operasyon. Para sa ilang mga operasyon sa balikat, maaari kang kailangang manatili sa ospital ng hindi bababa sa dalawang gabi. Ang pagtigil sa pagsusuka ay isang mahahalagang hakbang upang mapabuti ang iyong mga resulta at bawasan ang mga gastusin. Kahit hindi mo kayang tigilin nang lubusan, mahalagang pag-usapan ang iyong pagka-nicotine-dependent sa iyong doktor. Maaari silang tulungan kang i-optimize ang iyong kalusugan bago ang operasyon.

Ang paraang ito ay tama para sa iyo kung handa kang tigilan ang paggamit ng lahat ng mga produktong tabako bago ang iyong operasyon. Tinutulungan nito ang iyong katawan na gumaling nang mas mabuti at binabawasan ang iyong panganib ng mga problema. Malamang na hindi ito tama para sa iyo kung plano mong magpatuloy sa pagsusuka o paggamit ng smokeless tobacco. Ang pagpapatuloy sa mga gawi na ito ay maaaring magdulot ng nonunion (kung saan nabigo ang mga buto na pagsamahin), mga isyu sa paggaling ng tendon, at mas mataas na pagkakataon ng pagkakaroon ng kailangan para sa revision surgery. Ang iyong doktor ay magtatrabaho sa iyo upang lumikha ng isang plano na angkop sa iyong mga pangangailangan at nagpapataas ng iyong mga pagkakataon para sa matagumpay na paggaling.

Ang pangunahing aral

Ang pagsigarilyo, kabilang ang smokeless tobacco at mga pinainit na produkto, ay nagpapataas ng iyong panganib ng mga komplikasyon, sakit, at mahinang paggaling sa maraming mga operasyong orthopaedic. Maaari kang tulungan ng iyong doktor na matukoy ang mga panganing ito nang maaga. Ang paghinto sa pagsigarilyo ay isang mahalagang hakbang upang mapabuti ang iyong paggaling at mabawasan ang mga gastusin. Kahit na kumita ka lamang noong kamakailan, maaari pa ring harapin mo ang mas mataas na panganib ng impeksyon o operasyong revision kumpara sa mga taong hindi kumakain ng sigarilyo.

Evidence & references

Overview

Contemporary techniques and biologic augmentation may mitigate the adverse effects of smoking on radiographic fusion after combined TLIF and posterolateral lumbar (270°) arthrodesis [1].
Pack-years and duration of cessation serve as independent predictors of tendon healing after arthroscopic rotator cuff repair [2].
Surgeons should consider asking all patients with scaphoid fractures if they use smokeless tobacco or smoke to identify patients at risk for nonunions [3].
Active smokers are at an increased risk of both medical and surgical complications in elective knee or hip arthroplasty [4].
Heated tobacco users have worse clinical outcomes with respect to rotator cuff healing than nonsmokers, similar to conventional cigarette smokers [5].
Smokeless tobacco use is associated with worse outcomes following total knee arthroplasty [6].
Smoking is associated with a higher risk for complications than smokeless tobacco use [6].
Orthopaedic surgeons should consider evaluating non-tobacco nicotine dependence within their surgical optimization protocol for total knee arthroplasty [13].
Smokeless tobacco use is associated with increased perioperative complications and revision surgery after anterior cruciate ligament reconstruction [16].
Smokeless tobacco use is associated with increased perioperative complications and revision surgery after anterior cruciate ligament reconstruction [17].
Specific forms of tobacco use should be considered in preoperative screening for patients undergoing ACLR [16].
Specific forms of tobacco use should be considered in preoperative screening for patients undergoing ACLR [17].

How It Works

Contemporary surgical techniques and biologic augmentation may mitigate the adverse effects of smoking on radiographic fusion after combined TLIF and posterolateral lumbar (270°) arthrodesis [1].
Pack-years and duration of smoking cessation serve as independent predictors of tendon healing after arthroscopic rotator cuff repair [2].
Surgeons should include smokeless tobacco use in patient intake history to identify patients at risk for nonunions following scaphoid fractures [3].
Active smokers are at an increased risk of both medical and surgical complications compared to nonsmokers undergoing elective knee or hip arthroplasty [4].
Heated tobacco users have worse clinical outcomes regarding rotator cuff healing than nonsmokers, with effects similar to conventional cigarette smokers [5].
Smokeless tobacco use is associated with higher rates of medical- and joint-related complications following primary total hip arthroplasty [11].
Patient factors influencing lesser tuberosity healing in stemmed and stemless anatomic shoulder arthroplasty include tobacco use and body mass index [7].
Smoking is associated with higher residual pain and poorer functional outcomes at midterm follow-up after autologous osteochondral transplantation for osteochondral lesions of the talus [8].
Cessation of smoking is highly advised for meniscus repair, particularly when performed in the presence of concurrent ligamentous injury [9].
Smoking is a modifiable risk factor that should be addressed to improve outcomes and reduce costs associated with complications in patients undergoing shoulder arthroplasty [10].
Cigarette smoking was not associated with impaired radiographic fusion after TLIF with adjunctive posterolateral arthrodesis performed using a standardized technique [12].
All forms of tobacco products, including heated tobacco, adversely affect rotator cuff healing [14].
Nicotine has a dose-dependent effect on bone healing, bone growth, and implant integration [18].

What the Evidence Shows

Contemporary techniques and biologic augmentation may mitigate the adverse effects of smoking on radiographic fusion after combined TLIF and posterolateral lumbar (270°) arthrodesis [1].
Pack-years and duration of cessation serve as independent predictors of tendon healing after arthroscopic rotator cuff repair [2].
Surgeons should ask patients with scaphoid fractures if they use smokeless tobacco or smoke to identify patients at risk for nonunions [3].
Active smokers are at an increased risk of both medical and surgical complications following elective knee or hip arthroplasty [4].
Heated tobacco users have worse clinical outcomes with respect to rotator cuff healing than nonsmokers [5].
Smokeless tobacco use is associated with worse outcomes following total knee arthroplasty [6].
Smoking is associated with a higher risk for complications than smokeless tobacco use [6].
Patient factors that influence tuberosity healing after stemmed and stemless anatomic shoulder arthroplasty include greater BMI and tobacco use [7].
Smoking is associated with higher residual pain and poorer functional outcomes at midterm follow-up after autologous osteochondral transplantation for osteochondral lesions of the talus [8].
Cessation of smoking is highly advised for meniscus repair performed in the presence of concurrent ligamentous injury to reduce factors that may contribute to failure [9].
Smoking is a modifiable risk factor that should be addressed to improve outcomes and reduce costs associated with complications and joint replacement in patients undergoing shoulder arthroplasty [10].
Smokeless tobacco use is associated with higher rates of medical- and joint-related complications following primary total hip arthroplasty [11].
Cigarette smoking was not associated with impaired radiographic fusion after TLIF with adjunctive posterolateral arthrodesis performed using a standardized technique [12].
Orthopaedic surgeons should consider evaluating non-tobacco nicotine dependence within their surgical optimization protocol for total knee arthroplasty [13].
Heated tobacco use has a similar deleterious effect on rotator cuff repair healing as cigarette smoking [14].
Current smokers may have poorer functional outcomes after reverse total shoulder arthroplasty compared to former smokers and nonsmokers [15].
Smoking within 30 days of total knee arthroplasty was associated with greater postoperative pain and lower odds of achieving an acceptable pain state compared to former and never-smokers [20].
Non-smokers were significantly more likely to achieve superior functional outcomes following ACL reconstruction compared to smokers [21].
Current smokers and former smokers who quit smoking within 6 months of rotator cuff repair are at an elevated risk of postoperative infection and revision surgery at 90 days, 1 year, and 2 years postoperatively compared with never smokers [22].

Practical Considerations

Contemporary techniques and biologic augmentation may mitigate the adverse effects of smoking on radiographic fusion after combined TLIF and posterolateral lumbar (270°) arthrodesis [1].
Pack-years and duration of cessation serve as independent predictors of tendon healing after arthroscopic rotator cuff repair [2].
Surgeons should ask all patients with scaphoid fractures if they use smokeless tobacco or smoke to identify patients at risk for nonunions [3].
Active smokers are at an increased risk of both medical and surgical complications in elective knee or hip arthroplasty [4].
Heated tobacco users have worse clinical outcomes with respect to rotator cuff healing than nonsmokers, similar to conventional cigarette smokers [5].
Smokeless tobacco use is associated with worse outcomes following total knee arthroplasty [6].
Smoking is associated with a higher risk for complications than smokeless tobacco use [6].
Patient factors that influence lesser tuberosity healing in stemmed and stemless anatomic shoulder arthroplasty include greater BMI and tobacco use [7].
Smoking is associated with higher residual pain and poorer functional outcomes at midterm follow-up after autologous osteochondral transplantation for osteochondral lesions of the talus [8].
Cessation of smoking is highly advised for meniscus repair performed in the presence of concurrent ligamentous injury [9].
Smoking is a modifiable risk factor that should be addressed to improve outcomes and reduce costs associated with complications and joint replacement in patients undergoing shoulder arthroplasty [10].
Smokeless tobacco use is associated with higher rates of medical- and joint-related complications following primary total hip arthroplasty [11].
Cigarette smoking was not associated with impaired radiographic fusion after TLIF with adjunctive posterolateral arthrodesis performed using a standardized technique [12].
Orthopaedic surgeons should consider evaluating non-tobacco nicotine dependence within their surgical optimization protocol for total knee arthroplasty [13].
Current smokers may have poorer functional outcomes after reverse total shoulder arthroplasty compared to former smokers and nonsmokers, despite no significant difference in complication or revision surgery incidence [15].
Smokeless tobacco use is associated with increased perioperative complications and revision surgery after anterior cruciate ligament reconstruction [16].
Smokeless tobacco use is associated with increased perioperative complications and revision surgery after anterior cruciate ligament reconstruction [17].
Current or recent smokers may benefit from an inpatient setting of minimum 2 nights for outpatient total shoulder arthroplasty due to being an independent risk factor for complications [19].

Key Evidence

[L3] Contemporary techniques and biologic augmentation may mitigate the adverse effects of smoking in this setting. [1] (10.1097/corr.0000000000003999)
[L3] Pack-years and duration of cessation serve as independent predictors of tendon healing. [2] (10.1177/03635465261422620)
[L3] Surgeons should consider asking all patients with scaphoid fractures if they use smokeless tobacco or smoke and consider adding this to the patient's intake history to further identify patients at risk for nonunions. [3] (10.5435/jaaos-d-23-00188)
[L1] The literature reveals that active smokers are at an increased risk of both medical and surgical complications. [4] (10.1016/j.arth.2024.10.035)
[L3] Heated tobacco users, like conventional cigarette smokers, have worse clinical outcomes with respect to rotator cuff healing than nonsmokers. [5] (10.2106/jbjs.23.00804)
[L3] However, smoking is associated with higher risk for complications than smokeless tobacco use. [6] (10.1016/j.arth.2023.01.035)
[L3] In addition to the surgical technique, patient factors that influence tuberosity healing include a greater BMI and tobacco use. [7] (10.3390/jcm12030834)
[L3] However, smoking is associated with higher residual pain and poorer functional outcomes at midterm follow-up, despite no significant differences in activity levels based on Tegner scores. [8] (10.1186/s13018-025-06428-1)
[L2] Nevertheless, MAT and meniscus repair performed in the presence of concurrent ligamentous injury require reduction of factors that may contribute to failure, and cessation of smoking is highly advised. [9] (10.1530/eor-24-0097)
[L1] Smoking is a modifiable risk factor that should be addressed to improve outcomes and reduce the costs associated with complications and joint replacement in patients undergoing shoulder arthroplasty. [10] (10.1177/17585732251327368)
[L3] Smokeless tobacco use is associated with higher rates of medical- and joint-related complications following primary THA. [11] (10.1016/j.arth.2023.05.041)
[L2] Cigarette smoking was not associated with impaired radiographic fusion after TLIF with adjunctive posterolateral arthrodesis performed using a standardized technique. [12] (10.1097/corr.0000000000003844)
[L3] Orthopaedic surgeons should consider evaluating non-tobacco nicotine dependence within their surgical optimization protocol. [13] (10.5435/jaaos-d-23-01053)
[L4] This novel study shows that heated tobacco use has a similar deleterious effect on rotator cuff repair healing as cigarette smoking. [14] (10.2106/jbjs.24.00192)
[L3] Current smokers may have poorer functional outcomes after rTSA compared to former smokers and nonsmokers, despite the incidence of complications and revision surgery not differing significantly between cohorts. [15] (10.1016/j.jse.2024.07.052)
[L3] These findings highlight the importance of considering specific forms of tobacco use in preoperative screening for patients undergoing ACLR. [16] (10.1177/03635465241303487)
[L3] These findings highlight the importance of considering specific forms of tobacco use in preoperative screening for patients undergoing ACLR. [17] (10.1177/2325967125s00229)
[L2] Nicotine has a dose-dependent effect on bone healing, bone growth, and implant integration, as demonstrated in various animal and in vitro studies. [18] (10.1186/s13018-026-06733-3)
[L3] Current or recent smokers may benefit from an inpatient setting of minimum 2 nights. [19] (10.1016/j.jseint.2023.07.009)
[L3] Smoking within 30 days of TKA was associated with greater postoperative pain and lower odds of achieving an acceptable pain state compared to former and never-smokers. [20] (10.1016/j.arth.2026.04.018)
[L1] Nonetheless, non-smokers were significantly more likely to achieve superior functional outcomes following ACL reconstruction. [21] (10.1002/ksa.70146)
[L3] Current smokers and former smokers who quit smoking within 6 months of rotator cuff repair are at an elevated risk of postoperative infection and revision surgery at 90 days, 1 year, and 2 years postoperatively compared with never smokers. [22] (10.1016/j.jse.2023.03.007)

References

[1] Editor’s Spotlight/Take 5: Cigarette Smoking Was Not Associated With Lower Odds of Radiographic Fusion After Combined TLIF and Posterolateral Lumbar (270°) Arthrodesis: A CT-based Retrospective Cohort Evaluation. Clinical Orthopaedics & Related Research. 2026. DOI: 10.1097/corr.0000000000003999 [2] Duration of Smoking Cessation Needed to Achieve Retear Rates Comparable to Those of Nonsmokers After Arthroscopic Rotator Cuff Repair. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465261422620 [3] The Snuffbox: The Effect of Smokeless Tobacco Use on Scaphoid Fracture Healing. Journal of the American Academy of Orthopaedic Surgeons. 2023. DOI: 10.5435/jaaos-d-23-00188 [4] Should Smoking Cessation Be Recommended and Required for Patients Undergoing Elective Knee or Hip Arthroplasty?. The Journal of Arthroplasty. 2025. DOI: 10.1016/j.arth.2024.10.035 [5] Heated Tobacco Products Have Detrimental Effects on Rotator Cuff Healing, Similar to Conventional Cigarettes. Journal of Bone and Joint Surgery. 2024. DOI: 10.2106/jbjs.23.00804 [6] Smokeless Tobacco Use is Associated With Worse Outcomes Following Total Knee Arthroplasty. The Journal of Arthroplasty. 2023. DOI: 10.1016/j.arth.2023.01.035 [7] Lesser Tuberosity Osteotomy Healing in Stemmed and Stemless Anatomic Shoulder Arthroplasty Is Higher with a Tensionable Construct and Affected by Body Mass Index and Tobacco Use. Journal of Clinical Medicine. 2023. DOI: 10.3390/jcm12030834 [8] Smoking is associated with inferior postoperative outcomes after autologous osteochondral transplantation for osteochondral lesions of the talus: a minimum 5-year clinical follow-up study. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-06428-1 [9] The impact of smoking on meniscus surgery: a systematic review. EFORT Open Reviews. 2025. DOI: 10.1530/eor-24-0097 [10] Influence of smoking on shoulder arthroplasty outcomes: A meta-analysis of postoperative complications. Shoulder & Elbow. 2025. DOI: 10.1177/17585732251327368 [11] Smokeless Tobacco Use is Associated With Worse Medical and Surgical Outcomes Following Total Hip Arthroplasty. The Journal of Arthroplasty. 2024. DOI: 10.1016/j.arth.2023.05.041 [12] Cigarette Smoking Was Not Associated With Lower Odds of Radiographic Fusion After Combined TLIF and Posterolateral Lumbar (270°) Arthrodesis: A CT-based Retrospective Cohort Evaluation. Clinical Orthopaedics & Related Research. 2026. DOI: 10.1097/corr.0000000000003844 [13] Non-Tobacco Nicotine Dependence and Rates of Postoperative Complications in Total Knee Arthroplasty: A Propensity-Matched Comparison. Journal of the American Academy of Orthopaedic Surgeons. 2024. DOI: 10.5435/jaaos-d-23-01053 [14] All Forms of Tobacco Products Adversely Affect Rotator Cuff Healing. Journal of Bone and Joint Surgery. 2024. DOI: 10.2106/jbjs.24.00192 [15] The effect of smoking on outcomes of reverse total shoulder arthroplasty. Journal of Shoulder and Elbow Surgery. 2025. DOI: 10.1016/j.jse.2024.07.052 [16] Association of Smokeless Tobacco Use With Perioperative Complications and Revision Surgery After Anterior Cruciate Ligament Reconstruction. The American Journal of Sports Medicine. 2025. DOI: 10.1177/03635465241303487 [17] Poster 132: Smokeless Tobacco Use is Associated with Increased Perioperative Complications and Revision Surgery After Anterior Cruciate Ligament Reconstruction. Orthopaedic Journal of Sports Medicine. 2025. DOI: 10.1177/2325967125s00229 [18] The effect of non-tobacco nicotine on bone healing: a systematic review and application to total joint arthroplasty. Journal of Orthopaedic Surgery and Research. 2026. DOI: 10.1186/s13018-026-06733-3 [19] Smoking is an independent risk factor for complications in outpatient total shoulder arthroplasty. JSES International. 2023. DOI: 10.1016/j.jseint.2023.07.009 [20] Impact of Smoking Status on Early Outcomes and Healthcare Utilization Following Primary Total Knee Arthroplasty: A Retrospective Cohort Study. The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2026.04.018 [21] Tobacco's toll: Comparable anterior cruciate ligament graft failure rates and inferior functional outcomes in smokers compared to non‐smokers: A systematic review and meta‐analysis. Knee Surgery, Sports Traumatology, Arthroscopy. 2025. DOI: 10.1002/ksa.70146 [22] Does timing matter? The effect of preoperative smoking cessation on the risk of infection or revision following rotator cuff repair. Journal of Shoulder and Elbow Surgery. 2023. DOI: 10.1016/j.jse.2023.03.007