tobacco (chewing tobacco) use is strongly correlated with a significantly higher risk of both joint-specific and systemic medical complications following a primary Total Knee Arthroplasty (TKA).
While many patients historically assumed that chewing tobacco was safer than smoking because it eliminates smoke-related lung issues, peer-reviewed orthopedic data indicates that the nicotine present in smokeless tobacco causes severe vasoconstriction, which directly compromises bone integration, tissue healing, and immune responses.
Orthopedic surgeons typically recommend a total nicotine cessation window of two months prior to surgery and two months after surgery to minimize these risks and optimize joint survival.
Dr. Dev Padia
Specialist Orthopaedic Pain Doctor, Fractures-Ligaments Injury Surgeon and Expert Knee and Hip Replacement Surgeon, Surat, Gujarat, India.