Orthopedic Surgeon Recommends Refusing Knee Replacement Surgery for Smokers

According to an article at Health Day, an orthopedic surgeon has recommended that patients who smoke should not be allowed to undergo joint replacement surgery, as a recent study shows that smokers have a significantly higher rate of failure and complications following this type of surgery.

The recommendation came at a forum on joint replacement surgery held at the annual meeting of the American Academy of Orthopaedic Surgeons in San Francisco last week, where two studies were presented which showed substantially higher rates of surgical failure and surgical complications in smokers following joint replacement or joint reconstruction surgery.

According to the article: "At the forum, experts offered suggestions about how to get patients to quit smoking. One way is to refuse to perform surgery on patients who smoke, said Dr. Glenn Rechtine, an orthopedic surgeon and associate chief of staff and adjunct professor at the University of South Florida in Tampa. He said this rule has convinced 40 percent of his patients to stop smoking."

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Perhaps I'm misinterpreting his comment, but from what Dr. Rechtine stated, it appears that 60% of his smoking patients who need knee replacement surgery fail to qualify for this surgery because they are unable to quit smoking. In essence, these patients are being deprived a needed surgery as a punishment for being addicted to cigarettes. This is a harsh and brutal punishment that is not only inappropriate, but is in violation of the basic principles of medical practice.

The punishment will not only result in pain and suffering for these patients, but it will decrease their quality of life, as they will be unable to ambulate, exercise, and obtain physical activity to the degree they would like to. This, of course, will also have adverse health implications for them. Why should these people be punished so severely -- by the refusal of needed medical treatment and the imposition of pain and a decreased quality of life - for being unable to break an addiction that only 3% of smokers in the general population are able to break each year?

Fortunately, the rest of the physicians speaking at the forum appeared to have a more enlightened view on the subject and none of them echoed Dr. Rechtine's suggestion of refusing surgery to smokers.