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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.


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.