• Hussain Zaidi, John Stammers, Ahmed Hafez, Philip Mitchell, Sulaiman Alazzawi, Alexandros Maris, and Alexander Maslaris.
• Department of Trauma and Orthopaedic Surgery, Complex Arthroplasty Unit, St Georges University Hospital NHS Trust, London, UK. m2202239@sgul.ac.uk.
• Arch Orthop Trauma Surg. 2024 Nov 1; 144 (11): 480148084801-4808.

BackgroundCigarette smoking is known to result in poorer outcomes for patients undergoing total joint arthroplasty. Smoking tobacco cigarettes in the perioperative period is associated with higher analgesia usage, increased mortality, poorer healing, and an increased risk of medical complications. As such, many surgeons advise their patients not to smoke in the perioperative period. Electronic cigarettes are emerging as a popular alternative for usage by patients who would otherwise continue to smoke traditional cigarettes. Importantly, there has been limited investigation into the impact of electronic cigarette usage on the outcomes of total joint arthroplasty. This review investigates the potential detrimental effects caused by the usage of electronic cigarettes on the outcomes of total joint arthroplasty.MethodsA systematic review was carried out in accordance with the PRISMA Guidelines. We have drawn from studies that investigated the impact of the constituents of E-cigarette vapour on bone health, wound healing, the immune system and the direct impact of electronic cigarette usage on surgical outcomes.ResultsElectronic cigarettes release nicotine in an inconsistent manner, resulting in many negative consequences for bone health. Furthermore, they depress the immune system, impair wound healing and may result in longer hospital stays.ConclusionsElectronic cigarette usage should be monitored in the perioperative period to reduce the risk of complication. There is a pressing need for more comprehensive research in this area to fully understand the implications of EC usage on the outcomes of total joint arthroplasty.© 2024. The Author(s).

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