title: Smoking and alcohol behaviours in people following hip and knee arthroplasty: Data from the Osteoarthritis Initiative.
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.
  
  
  OBJECTIVE
  Smoking and alcohol consumption differs between pre- and post-THA/TKA and it differs between non-arthroplasty cohorts.
  
  
  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.
  
  
  METHODS
  Level III - prospective case control study.
authors: Faculty of Medicine and Health Sciences, School of Health Sciences, University of East Anglia, Norwich, United Kingdom. Electronic address: toby.smith@uea.ac.uk.
authors: T O
authors: TO
authors: Smith
authors: Physiotherapy Department, St. Bartholomew's Hospital, London, United Kingdom. Electronic address: florencepenny@gmail.com.
authors: F
authors: F
authors: Penny
authors: Norwich Medical School, University of East Anglia, Norwich, United Kingdom. Electronic address: R.Fleetcroft@uea.ac.uk.
authors: R
authors: R
authors: Fleetcroft
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology*; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery; D011184:Postoperative Period; D057234:Preoperative Period; D015995:Prevalence; D011446:Prospective Studies; D012907:Smoking / Q000453:epidemiology*
keywords: Alcohol consumption; Complication; Joint replacement; Morbidity; Smoking