Consultant orthopaedic surgeon Mr Sulaiman Alazzawi in collaboration with colleagues from the Complex Arthroplasty Unit at St George’s University Hospitals NHS Foundation Trust is an author on an important systematic review published in Archives of Orthopaedic and Trauma Surgery titled: “The impact of electronic cigarettes on the outcomes of total joint arthroplasty.”

Smoking tobacco is well-known to have negative consequences for major joint replacement surgery – including impaired wound healing, increased infection risk and poorer functional outcomes. The study extends this to include electronic cigarettes, which are frequently perceived as a safer alternative. The review was performed according to PRISMA guidelines and synthesises current data on e-cigarette vapour exposure, bone health, immune response and surgical outcomes.

Key findings show that e-cigarette vapour releases nicotine inconsistently, can depress immune function, impair wound healing and may prolong hospitalisation. The authors recommend that e-cigarette use be actively monitored before total hip and knee arthroplasty to reduce complication risks.

Mr Alazzawi commented: “This study is timely. Many patients and clinicians focus on tobacco smoking, but our findings highlight that vaping may also carry risks for complex joint surgery. We advise patients to follow their healthcare team’s lifestyle guidelines before and after surgery.”

For patients awaiting hip or knee replacement, the study emphasises not only surgical expertise, but also the role of comprehensive pre-operative preparation and lifestyle optimisation. For more advice, book an appointment with Mr Sulaiman Alazzawi.

The full text of the article can be accessed via PubMed (PMID: 39503768).