RESEARCH - Cigarette smoking and the risk for cartilage loss and knee pain in men with knee OA

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ls of the Rheumatic Diseases 2007;66:18-22

© 2007 by BMJ Publishing Group Ltd & European League Against Rheumatism

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EXTENDED REPORT

Cigarette smoking and the risk for cartilage loss and knee pain in men with

knee osteoarthritis

S Amin1, J Niu2, A Guermazi3, M Grigoryan3, D J Hunter2, M Clancy2, M P

LaValley2, H K Genant3 and D T Felson2

1 Division of Rheumatology, Mayo Clinic College of Medicine, Rochester,

Minnesota, USA

2 Clinical Epidemiology Research and Training Unit and Arthritis Center,

Boston University School of Medicine, Boston, Massachusetts, USA

3 Osteoporosis and Arthritis Research Group, University of California at San

Francisco, San Francisco, California, USA

Objective: To examine the effects of smoking on cartilage loss and pain at

the knee in individuals with knee osteoarthritis.

Methods: 159 men with symptomatic knee osteoarthritis who participated in a

30-month, prospective, natural history study of knee osteoarthritis were

examined. The more symptomatic knee was imaged using magnetic resonance

imaging (MRI) at baseline, and again at 15 and 30 months of follow-up.

Cartilage was scored using the Whole-Organ MRI Score semiquantitative method

at the medial and lateral tibiofemoral joints and at the patellofemoral

joint. At baseline and follow-up visits, the severity of knee pain was

assessed using a Visual Analogue Scale pain score (0-100 mm).

Results: Among the 159 men, 19 (12%) were current smokers at baseline.

Current smokers were younger (mean (standard deviation (SD)) age 62 (9) v 69

(9) years) and leaner (mean (SD) body mass index (BMI): 28.9 (3.2) v 31.3

(4.8) kg/m2) than men who were not current smokers. When adjusted for age,

BMI and baseline cartilage scores, men who were current smokers were found

to have an increased risk for cartilage loss at the medial tibiofemoral

joint (odds ratio (OR) 2.3, 95% confidence interval (CI) 1.0 to 5.4) and the

patellofemoral joint (OR 2.5, 95% CI 1.1 to 5.7). Current smokers also had

higher adjusted pain scores at baseline (60.5 v 45.0, p<0.05) and at

follow-up (59.4 v 44.3, p<0.05) than men who were not current smokers.

Conclusions: Men with knee osteoarthritis who smoke sustain greater

cartilage loss and have more severe knee pain than men who do not smoke.

http://ard.bmj.com/cgi/content/abstract/66/1/18?etoc

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