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吸烟与骨骼肌肉愈合 资料

本页面由机器翻译，尚未经临床医生审核。英文版本为权威版本。

您的感受

吸烟及其他烟草产品会影响您在骨科手术后的愈合过程。您可能会发现恢复时间比预期更长。您的外科医生会询问所有形式的烟草使用情况，包括无烟烟草，以了解您的具体风险。这有助于我们为您制定最佳的治疗方案。

如果您接受膝关节或髋关节置换手术，主动吸烟会增加医疗和手术并发症的风险。无烟烟草也与全膝关节置换术后更差的预后相关。它可能导致术中及术后出现更多问题，包括需要翻修手术的几率增加。您可能会感到手术部位疼痛加剧或愈合缓慢。

对于肩部手术，如肩袖修复术，您吸烟的年数以及戒烟的时间长短都很重要。加热烟草使用者的愈合结果通常与吸食传统香烟者相似。在肌腱愈合过程中，您可能会感到肩部僵硬或无力。如果愈合延迟，向后伸手扣内衣或把衬衫塞进裤子里可能会变得困难。

如果您患有腕部舟骨骨折，使用无烟烟草或吸烟会使您面临骨不连的风险。这意味着骨骼可能无法正确愈合。您可能会感到腕部持续疼痛，且休息后无法缓解。您的外科医生会筛查这些习惯，以便早期识别风险。

对于前交叉韧带重建术，使用无烟烟草与围手术期并发症增加及翻修手术风险相关。您可能会面临移植物失败或需要再次手术的风险。术前筛查会考虑这些特定形式的烟草使用，以优化您的手术效果。

在联合经椎间孔腰椎椎体间融合术（TLIF）和后外侧腰椎融合术中，现代技术和生物增强可能有助于减轻吸烟对脊柱融合术的负面影响。然而，避免使用烟草仍然是支持身体自然愈合过程的最佳方式。您的外科医生还可能将非烟草尼古丁依赖评估作为手术优化方案的一部分。了解这些因素有助于您为更顺利的康复之旅做好准备。

实际发生的情况

当您吸烟时，您的身体难以修复受损组织。这会影响您的骨骼、肌腱和关节。您的外科医生需要知道您是否使用任何形式的烟草。这包括香烟、无烟烟草或加热烟草产品。所有这些形式都会延缓您的恢复。

您的血液携带氧气和营养物质以帮助修复损伤。吸烟会减少这种供应。例如，在肩袖修复术后，您吸烟的年数以及术前戒烟的时间可以预测您的肌腱愈合情况。加热烟草使用者面临与吸烟者相似的愈合挑战。

无烟烟草也会引起问题。它与膝关节置换术后更差的预后相关。它还会增加前交叉韧带重建术后并发症的风险以及翻修手术的需求。这条韧带稳定您的膝盖。如果您的手腕发生舟骨骨折，您的外科医生可能会询问无烟烟草的使用情况。这有助于识别骨不连（骨骼未能愈合）高风险患者。

即使您不吸烟，尼古丁依赖也可能影响您的愈合。骨科外科医生应在您进行膝关节置换术前评估非烟草类尼古丁依赖。与不吸烟者相比，主动吸烟者在择期髋关节或膝关节置换术期间面临更高的医疗和手术并发症风险。吸烟与并发症风险增加相关，其风险高于无烟烟草使用。

现代技术和生物辅助手段可能有助于降低这些风险。这在复杂的脊柱融合手术中尤为如此。然而，避免使用烟草仍然是支持您身体自然愈合过程的最佳方式。您的外科医生希望您愈合良好并避免额外的手术。

预期情况

吸烟会影响您在骨科手术后的愈合过程。它会增加您出现医疗和外科并发症的风险。这种情况同样适用于择期的膝关节或髋关节置换术。它也适用于肩袖修复、舟骨骨折治疗和前交叉韧带重建等手术。您的外科医生很可能会询问您所有形式的烟草使用情况。这包括无烟烟草和香烟。即使您不吸烟，他们也可能检查您是否存在尼古丁依赖。

您的愈合情况取决于您的吸烟量以及术前戒烟的持续时间。对于肌腱修复，包年数和戒烟持续时间可预测愈合情况。加热烟草使用者的预后与常规香烟吸烟者相似，均较差。无烟烟草的使用与膝关节置换和韧带重建术后更高的并发症率和翻修手术率相关。吸烟导致并发症的风险高于无烟烟草的使用。

尽管存在这些风险，现代技术可能有所帮助。生物治疗有时可以减少复杂脊柱手术后吸烟对骨融合的负面影响。然而，无烟烟草仍会恶化膝关节置换术后的预后。如果您继续使用烟草，您的恢复期可能会更长且更困难。您可能会经历更多疼痛或需要额外的手术。如果您在术前停止使用烟草，顺利恢复的机会将会提高。您的外科医生希望帮助您良好愈合。请如实告知您的习惯，以便他们为您制定最佳的治疗计划。

Reviewed by Kieran Hirpara · 13 June 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

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].
  • Specific forms of tobacco use should be considered in preoperative screening for patients undergoing ACLR [16].

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

  • 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].
  • Patient factors that influence tuberosity healing after stemmed and stemless anatomic shoulder arthroplasty include greater BMI and tobacco use [7].
  • 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].
  • 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

  • Surgeons should ask all patients with scaphoid fractures if they use smokeless tobacco or smoke to identify patients at risk for nonunions [3].
  • Patient factors that influence lesser tuberosity healing in stemmed and stemless anatomic shoulder arthroplasty include greater BMI and tobacco use [7].
  • Cessation of smoking is highly advised for meniscus repair performed in the presence of concurrent ligamentous injury [9].
  • 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].
  • 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

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