Bisphosphonates Use After Total Joint Arthroplasty

Study Overview
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Brief Summary
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Background Bisphosphonates has been associated with a decreased risk of revision total joint replacements because of its effects on decreased periprosthetic bone loss and prosthetic migration. However, the results in the early literature are inconsistent and the influence of bisphosphonates on associated complications and subsequent total joint arthroplasty (TJA) remains unknown. This study is to investigate the association between the use of bisphosphonates and risk of adverse outcomes after primary TJA. Materials and Methods This matched cohort study utilized National Health Insurance Research Database in Taiwan to identify patients who underwent primary TJA over a 15-year period (January 2000- December 2015 inclusive). Study participants were further categorized into two groups: bisphosphonates users and nonusers, using propensity score matching. The Kaplan-Meier curve analysis and adjusted hazard ratios (aHR) of revision surgery, adverse outcomes of primary surgery and undergoing subsequent TJA were calculated using Cox regression analysis.

Official Title
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Postoperative Use of Bisphosphonates Reduces Adverse Outcome After Primary Total Joint Arthroplasty: A Nationwide Population-based Cohort Study

Conditions
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Diphosphonates

Intervention / Treatment
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* Drug: Bisphosphonates, Combinations


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients who underwent primary total joint arthroplasty during the study period (January 1, 2000 to December 31, 2015). Exclusion Criteria: Patients with total joint arthroplasty before the index date, Patients with existing pathologic fracture, nonunion of fracture and partial joint replacement, Patients who were lost to follow-up Patients < 40 years old

Ages Eligible for Study
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Minimum Age: 40 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| bisphosphonates users<br>Patients who underwent primary total joint arthroplasty with bisphosphonates use | Drug: Bisphosphonates, Combinations<br> <br> |
| bisphosphonates nonusers<br>Patients who underwent primary total joint arthroplasty without bisphosphonates use | Drug: Bisphosphonates, Combinations<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| revision rate of joint arthroplasty | revision rate of joint arthroplasty after primary surgery | a 15-year period (January 2000- December 2015 inclusive) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The rate of secondary total joint arthroplasty | The rate of secondary total joint arthroplasty | a 15-year period (January 2000- December 2015 inclusive) | 
| The rate of periprosthetic joint infection | The rate of periprosthetic joint infection | a 15-year period (January 2000- December 2015 inclusive) | 
| The rate of periprosthetic fracture | The rate of periprosthetic fracture | a 15-year period (January 2000- December 2015 inclusive) | 
| Mortality rate | Mortality rate | a 15-year period (January 2000- December 2015 inclusive) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Bisphosphonates, Total joint arthroplasty, Revision surgery, Periprosthetic fracture