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Bisphosphonate Use and Risk of Implant Revision after Total Hip/Knee Arthroplasty: A Meta-Analysis of Observational Studies.

Teng S, Yi C, Krettek C, Jagodzinski M - PLoS ONE (2015)

Bottom Line: To calculate the pooled risk ratios (RRs) with 95% confidential intervals (CIs), a fixed- or random-effects model was applied based on the heterogeneity across studies.However, due to limited number of the included studies, the findings of the present study should be treated with caution.More well-designed studies are required to further confirm our findings.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, P. R. China; Department of Orthopedic Trauma, Hannover Medical School, Hanover, Germany.

ABSTRACT

Objective: Several studies investigated the association between bisphosphonate use and the risk of implant revision after total hip or knee arthroplasty (THA or TKA); However, the findings were inconsistent. We performed this meta-analysis to evaluate the overall relative risk of such an event.

Methods: We searched the PubMed, EMBASE and Cochrane library databases to identify relevant publications on April 22, 2015. To calculate the pooled risk ratios (RRs) with 95% confidential intervals (CIs), a fixed- or random-effects model was applied based on the heterogeneity across studies.

Results: Three cohort studies and one case-control study were included in this meta-analysis. Compared with the bisphosphonate nonusers, the patients who used bisphosphonates for a long period of time had a significantly decreased risk of implant revision after THA/TKA (summary adjusted RR = 0.48, 95% CI: 0.38-0.61), and the summary adjusted RRs for the users who underwent THA and those who underwent TKA were 0.47 (95% CI: 0.36-0.61) and 0.45 (95% CI: 0.21-0.95), respectively.

Conclusions: Long-term use of bisphosphonates is correlated with a significantly decreased risk of implant revision after THA/TKA. However, due to limited number of the included studies, the findings of the present study should be treated with caution. More well-designed studies are required to further confirm our findings.

No MeSH data available.


Related in: MedlinePlus

Forest plot of the association between bisphosphonate use and risk of implant revision after total knee arthroplasty (A: adjusted RR; B: crude RR).
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pone.0139927.g003: Forest plot of the association between bisphosphonate use and risk of implant revision after total knee arthroplasty (A: adjusted RR; B: crude RR).

Mentions: The revision risk of TKA was documented in 2 studies. There was no heterogeneity between the 2 studies (I2 = 0%). We found a significantly reduced risk of revision surgery in the bisphosphonate users than in nonusers (summary crude RR = 0.45, 95% CI: 0.26–0.78; summary adjusted RR = 0.45, 95%: 0.21–0.95) (Fig 3).


Bisphosphonate Use and Risk of Implant Revision after Total Hip/Knee Arthroplasty: A Meta-Analysis of Observational Studies.

Teng S, Yi C, Krettek C, Jagodzinski M - PLoS ONE (2015)

Forest plot of the association between bisphosphonate use and risk of implant revision after total knee arthroplasty (A: adjusted RR; B: crude RR).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4596810&req=5

pone.0139927.g003: Forest plot of the association between bisphosphonate use and risk of implant revision after total knee arthroplasty (A: adjusted RR; B: crude RR).
Mentions: The revision risk of TKA was documented in 2 studies. There was no heterogeneity between the 2 studies (I2 = 0%). We found a significantly reduced risk of revision surgery in the bisphosphonate users than in nonusers (summary crude RR = 0.45, 95% CI: 0.26–0.78; summary adjusted RR = 0.45, 95%: 0.21–0.95) (Fig 3).

Bottom Line: To calculate the pooled risk ratios (RRs) with 95% confidential intervals (CIs), a fixed- or random-effects model was applied based on the heterogeneity across studies.However, due to limited number of the included studies, the findings of the present study should be treated with caution.More well-designed studies are required to further confirm our findings.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, P. R. China; Department of Orthopedic Trauma, Hannover Medical School, Hanover, Germany.

ABSTRACT

Objective: Several studies investigated the association between bisphosphonate use and the risk of implant revision after total hip or knee arthroplasty (THA or TKA); However, the findings were inconsistent. We performed this meta-analysis to evaluate the overall relative risk of such an event.

Methods: We searched the PubMed, EMBASE and Cochrane library databases to identify relevant publications on April 22, 2015. To calculate the pooled risk ratios (RRs) with 95% confidential intervals (CIs), a fixed- or random-effects model was applied based on the heterogeneity across studies.

Results: Three cohort studies and one case-control study were included in this meta-analysis. Compared with the bisphosphonate nonusers, the patients who used bisphosphonates for a long period of time had a significantly decreased risk of implant revision after THA/TKA (summary adjusted RR = 0.48, 95% CI: 0.38-0.61), and the summary adjusted RRs for the users who underwent THA and those who underwent TKA were 0.47 (95% CI: 0.36-0.61) and 0.45 (95% CI: 0.21-0.95), respectively.

Conclusions: Long-term use of bisphosphonates is correlated with a significantly decreased risk of implant revision after THA/TKA. However, due to limited number of the included studies, the findings of the present study should be treated with caution. More well-designed studies are required to further confirm our findings.

No MeSH data available.


Related in: MedlinePlus