by: Kathleen A. Hogan, MD
Everyone who has surgery worries about what can go wrong. No surgery, no matter how minor, is without some risk. However there are a few things that you can do before having surgery which may reduce the risk of complications.
Yes, smoking can result in lung cancer. But there are more immediate risks for smokers having surgery. Studies have shown significantly increased risks of heart attacks, strokes, pneumonia, blood clots, infection, and death after surgery in smokers. Nicotine also impairs the body’s ability to heal surgical wounds, thereby increasing the risk of infection. Fractures heal more slowly in smokers and there is a risk that joint replacement implants will not properly adhere to the bone in smokers. It is recommended to stop smoking at least 6 weeks before your planned surgery.
No one likes, or needs to be told to lose weight. However, obesity may increase the risk of surgical complications such as heart attacks and urinary tract infections. The risk of infection after joint replacement rises exponentially in patients who are significantly overweight. These risks are further increased in patients with high blood pressure, diabetes, or heart disease. How do you know if you are overweight? Calculate your body mass index by dividing your weight (kg) by height squared (cm). In New Hampshire, approximately 36% of adults are overweight (BMI>25) and 26% are obese (BMI>30). Weight loss is not easy, but may decrease your risk of surgical complications.
Visit a Dentist
According to the CDC, more than 20% of adults have untreated cavities. Studies have shown that improving oral care preoperatively reduces the risk of pneumonia and mortality after cardiac surgery. Infections around the teeth can spread bacteria into the blood stream and can cause severe infections around total joint replacements. I ask my patients if they have untreated dental disease and postpone surgery until it is resolved. Only 61% of adults visited the dentist within the past year. Brush and floss daily and visit a dentist at least once each year.
Is it more difficult to stop smoking, lose weight, or get a root canal? None of these things are easy or fun to do. However, they are three steps that should be considered before having elective surgery in order to decrease the risk of complications. Discuss these issues with your doctor if you are planning on having joint replacement surgery.