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Current Concepts Review   |    
The Musculoskeletal Effects of Cigarette Smoking
John J. Lee, MD, MS1; Rakesh Patel, MD1; J. Sybil Biermann, MD2; Paul J. Dougherty, MD1
1 Department of Orthopaedic Surgery, University of Michigan, 2912 Taubman Center, 1500 East Medical Center Drive SPC 5328, Ann Arbor, MI 48109
2 Comprehensive Cancer Center, University of Michigan Health System, 1500 East Medical Center Drive, CC 7304/5946, Ann Arbor, MI 48109-5946.
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Investigation performed at the Comprehensive Cancer Center and the Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan



Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2013 May 01;95(9):850-859. doi: 10.2106/JBJS.L.00375
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Abstract

 ➤ Cigarette smoking decreases bone mineral density and increases the risk of sustaining a fracture or tendon injury, with partial reversibility of these risks with long-term cessation of smoking.

 ➤ Cigarette smoking increases the risk for perioperative complications, nonunion and delayed union of fractures, infection, and soft-tissue and wound-healing complications.

 ➤ Brief preoperative cessation of smoking may mitigate these perioperative risks.

 ➤ Informed-consent discussions should include notification of the higher risk of perioperative complications with cigarette smoking and the benefits of temporary cessation of smoking.

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    smoking
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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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