| Osteoarthritis (OA) is the most common form of | | | | not pinpoint why smoking was associated with knee |
| arthritis. It is due to premature wearing away of | | | | pain. It is not likely due to cartilage loss, since |
| cartilage, the gristle that cushions the ends of long | | | | cartilage does not have pain fibers, Felson stated. |
| bones in the joint. Known risk factors for knee OA | | | | "Instead, smoking may have direct effects on other |
| include a history of trauma, a family history of the | | | | articular structures mediating knee pain or may |
| disease, certain metabolic conditions, and obesity. A | | | | modify the threshold for musculoskeletal pain among |
| recent study has confirmed the suspicion that | | | | smokers," he said. Further study is needed to |
| smoking has another detrimental effect on health. It | | | | investigate the effects of smoking on knee |
| can worsen the prognosis of men who have | | | | osteoarthritis, the researchers added. One hypothesis |
| osteoarthritis of the knee. The study, performed by | | | | is that smoking may "turn on" proinflammatory |
| researchers from Boston University School of | | | | mechanisms in osteoarthritis. This may occur as a |
| Medicine and the Mayo Clinic and published in the | | | | result of the interaction of nicotine or other |
| January 2007 issue of the Annals of the Rheumatic | | | | ingredients and predisposing genetic markers a |
| Diseases, followed 159 men with knee osteoarthritis | | | | patient may possess. (Interestingly, cigarette smoking |
| for 30 months. Nineteen of the men were smokers. | | | | also is a risk factor for rheumatoid arthritis and the |
| After the researchers adjusted their study results for | | | | turning on of proinflammatory cytokines is felt to be |
| age, body mass index (a measure of weight in | | | | cause). It is critical for patients to understand the |
| relation to height) and baseline cartilage scores, they | | | | need to reduce any risk factors for arthritis they |
| found that the smokers were at increased risk of | | | | may have. For instance, if a patient already has a |
| cartilage loss and experienced more pain than the | | | | strong family history of osteoarthritis, they may |
| men who did not smoke. "Our findings also suggest | | | | want to avoid cigarette smoking altogether. Add this |
| smoking plays a role in the progression of | | | | potential medical problem to the long list of things |
| symptomatic knee osteoarthritis and, therefore, is a | | | | that smoking aggravates. |
| modifiable risk factor with important public health | | | | Nathan Wei, MD FACP FACR is a rheumatologist and |
| implications," Dr. David Felson, director of the Clinical | | | | Director of the Arthritis and Osteoporosis Center of |
| Epidemiology Research and Training Unit and | | | | Maryland. He is a Clinical Assistant Professor of |
| professor of medicine and public health at Boston | | | | Medicine at the University of Maryland School of |
| University School of Medicine. The researchers could | | | | Medicine. |