{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T18:19:55Z","timestamp":1791569995503,"version":"4.3.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2017,5,29]],"date-time":"2017-05-29T00:00:00Z","timestamp":1496016000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["HIP International"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Current studies demonstrate controversy regarding the relationship between cigarette smoking and osteonecrosis of the femoral head (ONFH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a meta-analysis to evaluate the association between smoking and ONFH. Relevant articles published before September 2016 were identified by a systematic search of EMBASE and MEDLINE via Ovid. Summary odds ratios (OR) were calculated using random effects models, and study quality was assessed using a modified Newcastle-Ottawa scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>102 citations were screened and 7 case-control studies were identified and included in the review. When compared with nonsmokers, current smokers had a higher risk of developing ONFH (OR 2.53; 95% confidence interval [CI] 1.68-3.79), as did former smokers (OR 1.82; 95% CI, 1.10-3.00). Within the group of current smokers, those classified as heavy smokers (with a daily number &gt;20 cigarettes\/day) demonstrated higher risks of ONFH (OR 2.03; 95% CI, 1.29-3.19), and light smokers classified as smoking &lt;20 cigarettes\/day, also demonstrated a higher risk of ONFH when compared with nonsmokers (OR 1.73; 95% CI, 1.06-2.83). When smoking was classified by pack-years, heavy smokers (&gt;20 pack-years) were at a higher risk of ONFH (OR 2.26; 95% CI, 1.24-4.13), but no significant difference in risk was identified in light smokers (&lt;20 pack-years) (OR 1.81; 95% CI, 0.88-3.71) when compared with nonsmokers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our meta-analysis showed that current smokers were at a higher risk of ONFH, this high risk can also be found in former smokers. And heavy cigarette smoking showed a higher risk of ONFH than light smoking.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5301\/hipint.5000516","type":"journal-article","created":{"date-parts":[[2017,6,3]],"date-time":"2017-06-03T12:38:02Z","timestamp":1496493482000},"page":"425-435","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":37,"title":["Influence of Cigarette Smoking on Osteonecrosis of the Femoral Head (ONFH): A Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"27","author":[{"given":"Zhenxing","family":"Wen","sequence":"first","affiliation":[{"name":"The College of Clinical Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing - China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zan","family":"Lin","sequence":"additional","affiliation":[{"name":"The College of Clinical Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing - China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenlong","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing - China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing - China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,5,29]]},"reference":[{"issue":"234","key":"bibr1-hipint.5000516","first-page":"115","author":"Matsuo K","year":"1988","journal-title":"Clin Orthop Relat Res"},{"key":"bibr2-hipint.5000516","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a116706"},{"issue":"277","key":"bibr3-hipint.5000516","first-page":"12","author":"Arlet J","year":"1992","journal-title":"Past, present, and future. 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