Does smoking cessation increase risk of knee replacement? a general population-based cohort study
C Zeng1, U-S D T Nguyen2, J Wu3
1Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China; Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA; The Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Osteoarthritis and Cartilage
|February 23, 2021
Summary
Quitting smoking may increase the risk of knee replacement surgery in individuals with knee osteoarthritis, particularly if weight gain occurs after cessation. This finding highlights the importance of weight management post-smoking cessation for knee osteoarthritis patients.
Area of Science:
- Public Health
- Epidemiology
- Rheumatology
Background:
- Smoking is a significant global public health concern.
- Previous studies on smoking and knee osteoarthritis risk have yielded inconsistent results due to methodological challenges.
Purpose of the Study:
- To investigate the association between smoking cessation and the risk of knee replacement in patients with knee osteoarthritis.
- To analyze how weight changes after smoking cessation influence this risk.
Main Methods:
- A cohort study was conducted using The Health Improvement Network database.
- Participants were categorized into current smokers and recent quitters, with quitters further grouped by weight change (gain, no change, loss) after cessation.
- Risk of knee replacement was assessed using adjusted hazard ratios (HR).
Main Results:
- Smoking cessation was associated with an increased risk of knee replacement (HR = 1.30).
- The risk was significantly higher among quitters who experienced weight gain (HR = 1.42).
- No significant increase in risk was observed for quitters with no substantial weight change or weight loss.
Conclusions:
- Smoking cessation is linked to a higher risk of knee replacement in individuals with knee osteoarthritis.
- Weight gain following smoking cessation appears to be the primary driver of this increased risk.
- These findings underscore the need for weight management strategies in conjunction with smoking cessation for knee osteoarthritis patients.
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