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Effect of bisphosphonates on knee replacement surgery
Tuhina Neogi1, Shanshan Li1, Christine Peloquin1
1Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, Massachusetts, USA.
Annals of the Rheumatic Diseases
|October 9, 2017
Summary
Bisphosphonate use in older women with knee osteoarthritis (OA) was associated with a reduced risk of knee replacement (KR) surgery. This study suggests bisphosphonates may offer a protective benefit for knee OA progression.
Area of Science:
- Orthopedics
- Rheumatology
- Pharmacology
Background:
- Knee osteoarthritis (OA) is a prevalent degenerative joint disease.
- Bone remodeling is a potential therapeutic target for OA.
- The efficacy of antiresorptive agents, like bisphosphonates, in knee OA remains unclear.
Purpose of the Study:
- To investigate the effect of bisphosphonate use on the risk of knee replacement (KR) surgery in older women with incident knee OA.
- To address the conflicting evidence regarding antiresorptive agents in knee OA treatment.
Main Methods:
- A population-based cohort study using The Health Improvement Network (THIN) electronic medical records.
- Propensity score matching was used to compare bisphosphonate initiators with non-initiators diagnosed with knee OA.
- Cox proportional hazard regression analysis assessed the risk of KR, with sensitivity analyses for residual confounding.
Main Results:
- 2006 bisphosphonate initiators were matched with 2006 non-initiators (mean age 76 years).
- Bisphosphonate initiators showed a 26% lower risk of KR compared to non-initiators (HR 0.74, 95% CI 0.59 to 0.93).
- Adjusted analyses and sensitivity analyses confirmed this protective association.
Conclusions:
- Bisphosphonate use in older women with knee OA is associated with a reduced likelihood of undergoing KR surgery.
- These findings suggest a potential beneficial role for bisphosphonates in managing knee OA.
- Further research is warranted to confirm these effects and explore underlying mechanisms.
