The Effect of Preoperative Bisphosphonate Use on Total Hip Arthroplasty Outcomes.

MedStar author(s):
Citation: Journal of Arthroplasty. 38(11):2393-2397.e2, 2023 11.PMID: 37236285Institution: MedStar Union Memorial HospitalDepartment: Orthopaedic SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Arthroplasty, Replacement, Hip | *Bone Diseases, Metabolic | *Osteoporosis | Arthroplasty, Replacement, Hip/ae [Adverse Effects] | Bone Diseases, Metabolic/co [Complications] | Bone Diseases, Metabolic/dt [Drug Therapy] | Diphosphonates/ae [Adverse Effects] | Humans | Osteoporosis/co [Complications] | Osteoporosis/dt [Drug Therapy] | Osteoporosis/ep [Epidemiology] | Postoperative Complications/ci [Chemically Induced] | Postoperative Complications/et [Etiology] | Reoperation/ae [Adverse Effects] | Retrospective Studies | Risk FactorsYear: 2023ISSN:
  • 0883-5403
Name of journal: The Journal of arthroplastyAbstract: BACKGROUND: Patients undergoing total hip arthroplasty (THA) commonly have osteoporosis for which bisphosphonates (BPs) are Food and Drug Administration (FDA)-approved for treatment. Bisphosphonate use post-THA is associated with decreased periprosthetic bone loss or revisions, and increased longevity of implants. However, evidence is lacking for preoperative bisphosphonate use in THA recipients. This study investigated the association between bisphosphonate use pre-THA and outcomes.CONCLUSION: The use of bisphosphonates in THA patients preoperatively is associated with higher rates of intraoperative and 1-year postoperative complications. These findings may impact the management of patients undergoing THA who have a prior diagnosis of osteoporosis/osteopenia and use of bisphosphonates.LEVEL OF EVIDENCE: Retrospective Cohort Study (Level 3). Copyright © 2023 Elsevier Inc. All rights reserved.METHODS: A retrospective review of a national administrative claims database was conducted. Among THA recipients who had a prior diagnosis of hip osteoarthritis and osteoporosis/osteopenia, the treatment group (BP-exposed) consisted of patients who had a history of bisphosphonate use at least 1 year before THA; controls (BP-naive) comprised patients who did not have preoperative bisphosphonate use. The BP-exposed were matched to BP-naive in a 1:4 ratio by age, sex, and comorbidities. Logistic regressions were used to calculate the odds ratio for intraoperative and 1-year postoperative complications.RESULTS: The BP-exposed group had significantly higher rates of intraoperative and 1-year postoperative periprosthetic fractures (odds ratio (OR): 1.39, 95% confidence interval (CI): 1.23, 1.57) and revisions (OR: 1.14, 95% CI: 1.04, 1.25) compared with the BP-naive controls. BP-exposed also experienced higher rates of aseptic loosening, dislocation, periprosthetic osteolysis, and stress fracture of the femur or hip/pelvis compared to the BP-naive controls, but these values were not statistically significant.All authors: Jeong S, Lee JW, Boucher HRFiscal year: FY2024Digital Object Identifier: Date added to catalog: 2024-01-16
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 37236285 Available 37236285

BACKGROUND: Patients undergoing total hip arthroplasty (THA) commonly have osteoporosis for which bisphosphonates (BPs) are Food and Drug Administration (FDA)-approved for treatment. Bisphosphonate use post-THA is associated with decreased periprosthetic bone loss or revisions, and increased longevity of implants. However, evidence is lacking for preoperative bisphosphonate use in THA recipients. This study investigated the association between bisphosphonate use pre-THA and outcomes.

CONCLUSION: The use of bisphosphonates in THA patients preoperatively is associated with higher rates of intraoperative and 1-year postoperative complications. These findings may impact the management of patients undergoing THA who have a prior diagnosis of osteoporosis/osteopenia and use of bisphosphonates.

LEVEL OF EVIDENCE: Retrospective Cohort Study (Level 3). Copyright © 2023 Elsevier Inc. All rights reserved.

METHODS: A retrospective review of a national administrative claims database was conducted. Among THA recipients who had a prior diagnosis of hip osteoarthritis and osteoporosis/osteopenia, the treatment group (BP-exposed) consisted of patients who had a history of bisphosphonate use at least 1 year before THA; controls (BP-naive) comprised patients who did not have preoperative bisphosphonate use. The BP-exposed were matched to BP-naive in a 1:4 ratio by age, sex, and comorbidities. Logistic regressions were used to calculate the odds ratio for intraoperative and 1-year postoperative complications.

RESULTS: The BP-exposed group had significantly higher rates of intraoperative and 1-year postoperative periprosthetic fractures (odds ratio (OR): 1.39, 95% confidence interval (CI): 1.23, 1.57) and revisions (OR: 1.14, 95% CI: 1.04, 1.25) compared with the BP-naive controls. BP-exposed also experienced higher rates of aseptic loosening, dislocation, periprosthetic osteolysis, and stress fracture of the femur or hip/pelvis compared to the BP-naive controls, but these values were not statistically significant.

English

Powered by Koha