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Smoking and alcohol behaviours in people following hip and knee arthroplasty: Data from the Osteoarthritis Initiative - 18/03/16

Doi : 10.1016/j.otsr.2015.12.005 
T.O. Smith a, , F. Penny b , R. Fleetcroft c
a Faculty of Medicine and Health Sciences, School of Health Sciences, University of East Anglia, Norwich, United Kingdom 
b Physiotherapy Department, St. Bartholomew's Hospital, London, United Kingdom 
c Norwich Medical School, University of East Anglia, Norwich, United Kingdom 

Corresponding author. Faculty of Medicine and Health Sciences, University of East Anglia, Queen's Building, Norwich Research Park, Norwich, NR4 7TJ, United Kingdom. Tel.: +44 1603 593 087; fax: +44 1603 593 166.

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Abstract

Background

Smoking and alcohol consumption has a negative effect on overall health. Limited evidence has been presented as to how these health behaviours may change between pre- and postoperative intervals in the initial 12 months post-arthroplasty. The purpose of this study was to address this uncertainty.

Hypothesis

Smoking and alcohol consumption differs between pre- and post-THA/TKA and it differs between non-arthroplasty cohorts.

Materials and methods

Data from the Osteoarthritis Initiative (OAI), a population-based observational study in the USA, were gathered. In total, data from 287 people who had undergone THA or TKA from baseline to month 48 OAI follow-up assessments were analysed. Data on this cohort were compared to 287 age- and gender-matched people with osteoarthritis. Mean change from pre- to post-arthroplasty, and differences between arthroplasty and non-arthroplasty participants for smoking and alcohol consumption were assessed descriptively and through Wilcoxin-matched pairs test and Student t-tests (as appropriate).

Results

The lifetime prevalence of smoking was high for people who received THA (99%) and TKA (96%). Prevalence of current smoking significantly decreased from 5 to 3% across the THA and TKA cohort in the initial 12 months post-arthroplasty (P<0.05). Similarly, there was a statistically significant decrease in weekly alcohol consumption post-arthroplasty for people who underwent THA and TKA (P<0.01), although the mean difference was only by 0.9 alcoholic drinks. The only statistically significant difference in smoking and alcohol consumption for arthroplasty to non-arthroplasty participants was in weekly alcohol consumption, which was higher by 0.3 drinks in the non-arthroplasty cohort (P=0.04).

Conclusions

Smoking and alcohol consumption decreased in the initial 12 months post-THA and TKA. This was not significantly different to an age- and gender-matched non-arthroplasty cohort. Whilst this is positive, a small group of patients still present with unhealthy lifestyle choices in relation to these behaviours post-arthroplasty.

Level of evidence

Level III – prospective case control study.

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Keywords : Joint replacement, Alcohol consumption, Smoking, Complication, Morbidity


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Vol 102 - N° 2

P. 239-245 - avril 2016 Retour au numéro
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