The Effect of Cigarette Smoking on Radiographic Bone Healing After Elective Foot Surgery

Krannitz, Kristopher W.; Fong, Hon W.; Fallat, Lawrence M.; Kish, John

doi:10.1053/j.jfas.2009.04.008

Cited by 65 publications

(47 citation statements)

References 8 publications

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“…Smokers were less responsive to periodontal therapy than non-smokers23. Cigarette smoking delays healing process1415 and impairs inflammatory and immune responses to periodontal pathogens, exerting both systemic and local effects24. However, the mechanisms of cigarette smoking on periodontal diseases are still unclear.…”

Section: Discussionmentioning

confidence: 99%

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Cigarette smoking hinders human periodontal ligament-derived stem cell proliferation, migration and differentiation potentials

Huang

Cao

et al. 2015

Sci Rep

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Cigarette smoking contributes to the development of destructive periodontal diseases and delays its healing process. Our previous study demonstrated that nicotine, a major constituent in the cigarette smoke, inhibits the regenerative potentials of human periodontal ligament-derived stem cells (PDLSC) through microRNA (miRNA) regulation. In this study, we hypothesized that the delayed healing in cigarette smokers is caused by the afflicted regenerative potential of smoker PDLSC. We cultured PDLSC from teeth extracted from smokers and non-smokers. In smoker PDLSC, we found significantly reduced proliferation rate and retarded migration capabilities. Moreover, alkaline phosphatase activity, calcium deposition and acidic polysaccharide staining were reduced after BMP2-induced differentiation. In contrast, more lipid deposition was observed in adipogenic-induced smoker PDLSC. Furthermore, two nicotine-related miRNAs, hsa-miR-1305 (22.08 folds, p = 0.040) and hsa-miR-18b (15.56 folds, p = 0.018), were significantly upregulated in smoker PDLSC, suggesting these miRNAs might play an important role in the deteriorative effects on stem cells by cigarette smoke. Results of this study provide further evidences that cigarette smoking affects the regenerative potentials of human adult stem cells.

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Section: Discussionmentioning

confidence: 99%

“…PDLSC enhance the disease healing process13. However, cigarette smoking has been found to delay this healing process14. Besides, the incidence of delayed healing is double in smokers than in non-smokers15, likely due to the inhibition of stem cell recruitment to tissues and regeneration by cigarette smoking1617.…”

mentioning

confidence: 99%

Cigarette smoking hinders human periodontal ligament-derived stem cell proliferation, migration and differentiation potentials

Huang

Cao

et al. 2015

Sci Rep

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“…There was on the whole very little information regarding how many cigarettes were being smoked and it is also of note that it was extremely rare for any biochemical confirmation of non-smoking status, that is, cotinine or carbon monoxide. 68 Study quality, severity of fracture or surgical procedure, age of patients, bone involved and non-union definition were identified as potential sources of heterogeneity. We have noticed that in all the studies where surgery for non-union is discussed, the percentage of smokers requiring surgical intervention is always higher than the non-smokers, but none of these studies have ascertained a statistical significance for this association.…”

Section: Strengths and Weaknessesmentioning

confidence: 99%

Do smokers have greater risk of delayed and non-union after fracture, osteotomy and arthrodesis? A systematic review with meta-analysis

et al. 2016

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ObjectivesSystematic review and meta-analysis of published observational cohort studies. To quantify the increased risk smokers have of experiencing a delayed and/or non-union in fractures, spinal fusion, osteotomy, arthrodesis or established non-unions.SettingMedical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica database (EMBASE), Allied and Complementary Medicine Database (AMED) and Web of Science Core Collection from 1966 to 2015.Study eligibility criteria, participants and interventionsObservational cohort studies that reported adult smokers and non-smokers with delayed and/or non-union or time to union of the fracture, spinal fusion, osteotomy, arthrodesis or established non-union were eligible.Data extraction and outcome measures2 authors screen titles, abstracts and full papers. Data were extracted by 1 author and checked independently by a second. The relative risk ratios of smoking versus non-smoking and the mean difference in time to union patients developing a delayed and/or non-union were calculated.ResultsThe search identified 3013 articles; of which, 40 studies were included. The meta-analysis of 7516 procedures revealed that smoking is linked to an increased risk of delayed and/or non-union. When considered collectively, smokers have 2.2 (1.9 to 2.6) times the risk of experiencing delayed and/or non-union. In all the subgroups, the increased risk was always ≥1.6 times that of non-smokers. In the patients where union did occur, it was a longer process in the smokers. The data from 923 procedures were included and revealed an increase in time to union of 27.7 days (14.2 to 41.3).ConclusionsSmokers have twice the risk of experiencing a non-union after fracture, spinal fusion, osteotomy, arthrodesis or treatment of non-union. Time to union following fracture, osteotomy, arthrodesis or treatment of an established non-union is longer in smokers. Smokers should be encouraged to abstain from smoking to improve the outcome of these orthopaedic treatments.

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“…Krannitz et al 23 investigated the effect of cigarette smoking on radiological bone healing after elective Austin bunionectomies with internal screw fixation. The study included 17 self-reported smokers and 17 non-smokers.…”

Section: Studies Based On Other Bonesmentioning

confidence: 99%

The effect of smoking on bone healing

Patel

Wilson

Patel

et al. 2013

Bone & Joint Research

179

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ObjectivesTo review the systemic impact of smoking on bone healing as evidenced within the orthopaedic literature.MethodsA protocol was established and studies were sourced from five electronic databases. Screening, data abstraction and quality assessment was conducted by two review authors. Prospective and retrospective clinical studies were included. The primary outcome measures were based on clinical and/or radiological indicators of bone healing. This review specifically focused on non-spinal orthopaedic studies.ResultsNine tibia studies and eight other orthopaedic studies were considered for systematic review. Of these 17 studies, 13 concluded that smoking negatively influenced bone healing.ConclusionsSmoking has a negative effect on bone healing, in terms of delayed union, nonunion and more complications.

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The Effect of Cigarette Smoking on Radiographic Bone Healing After Elective Foot Surgery

Cited by 65 publications

References 8 publications

Cigarette smoking hinders human periodontal ligament-derived stem cell proliferation, migration and differentiation potentials

Cigarette smoking hinders human periodontal ligament-derived stem cell proliferation, migration and differentiation potentials

Do smokers have greater risk of delayed and non-union after fracture, osteotomy and arthrodesis? A systematic review with meta-analysis

The effect of smoking on bone healing

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