Men who smoke have less risk of undergoing  total joint replacement (TJR)  surgery of the hip or knee than those who have never smoked, according to the results of an Australian cohort study reported online July 8 in Arthritis & Rheumatism.

 

"Our study is the first to demonstrate a strong inverse correlation between smoking duration and risk of total joint replacement," said lead author George Mnatzaganian, PhD, from the University of Adelaide in Adelaide, Australia, in a news release. "The independent inverse associations of smoking with risk of total joint replacement were evident also after adjusting for major confounders and after accounting for the competing mortality risk in this elderly cohort of men. Further investigation is needed to determine how smoking impacts the development of [osteoarthritis]."

 

In developed countries, total hip and knee replacements are among the most widely performed elective surgeries, with 230,000 people in the United States estimated to have had hip arthroplasty and 543,000 to have had knee arthroplasty in 2007, based on the National Hospital Discharge Survey.

Severe OA is the most common cause for arthroplasty, with known risk factors including older age, female sex, and obesity.

 

Using a cohort from the Health in Men Study of 11,388 men for whom clinical data, hospital morbidity data, and mortality records were available, the investigators aimed to examine the associations of smoking, body weight, and physical activity with the risk of undergoing TJR. During the initial health screening from 1996 to 1999, participants from the Health in Men Study provided information regarding smoking history and physical activity. Cox proportional hazards regressions and competing risk regressions allowed modeling of TJR risk in 3 separate age groups based on weight and height at baseline, comorbidity, injury, socioeconomic status, years of smoking, and exercise.

 

Clinical data were analyzed from baseline through March 2007. Of 857 men who had joint replacement surgery, 59.5% had total knee replacement, and 40.5% had total hip replacement.

 

Overweight was independently associated with an increased risk for TJR, whereas smoking was independently associated with a reduced risk, and there was a dose-response relationship for both associations. Cox and competing risk regressions models both showed reduced risk among smokers, which was evident after 23 years of smoking. Compared with never-smokers, men who were in the highest quartile (48-plus years of smoking) were 42% to 51% less likely to undergo TJR. Across smoking as well as across weight quantiles, tests for trend in the log hazard-ratios were significant (P < .05).

 

 

Ten to fifteen years ago, about half or more of the men I knew smoked. I did not know one person who ever had joint replacement surgery (TJR)

Today, I know or know of at least five people who have had TJR  surgery. They all had given up the tobacco habit many years prior, or had never smoked. TJR surgery is another multi million dollar industry today. $  Of course those who stopped smoking, at least two thirds of them replaced those nasty cigarettes with more eating, and  mostly unhealthy junk. They are all over-weight and or obese. About two out of ten I presently know also have diabetes. $  Carrying around a lot of extra weight of course leads to joint problems etc.  But at least their not smoking? $

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