Postoperative use of bisphosphonates and risk of revision after primary total hip arthroplasty: a nationwide population-based study

Bone
Theis M ThillemannKjeld Søballe

Abstract

Recently, bisphosphonates have been linked with mechanisms that may influence longevity of orthopedic implants. We therefore evaluated the association between the use of bisphosphonates and the risk of revision after primary total hip arthroplasty (THA). We conducted a nationwide population-based nested case-control study using medical databases in Denmark. From the Danish Hip Arthroplasty Register (DHR) we included primary THA patients diagnosed with either osteoporosis or a previous osteoporotic fracture (n=16,145). Among these patients we identified 632 cases that were revised after primary THA in the period 1995-2006. The cases were matched on gender, age and year of primary THA surgery with 1262 non-revised osteoporotic THA controls. Using conditional logistic regression we estimated the risk of revision due to all causes and due to specific causes according to postoperative bisphosphonate use. The 10-year cumulated implant revision rate in the underlying cohort of 16,145 primary THA procedures among osteoporotic patients was 8.3% (95% confidence interval (CI): 7.3-9.3). The use of bisphosphonates was associated with an adjusted relative risk of revision due to deep infections of 2.59 (95% CI; 1.30-6.53). Further, the dura...Continue Reading

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