即使在骨密度正常的患者中，使用双膦酸盐也可降低全膝关节置换翻修风险。
Lower Total Knee Arthroplasty Revision Risk Associated With Bisphosphonate Use, Even in Patients With Normal Bone Density.
作者信息
Namba Robert S, Inacio Maria C S, Cheetham T Craig, Dell Richard M, Paxton Elizabeth W, Khatod Monti X
机构信息
Southern California Permanente Medical Group, Irvine, California.
Kaiser Permanente, Surgical Outcomes and Analysis, San Diego, California.
出版信息
J Arthroplasty. 2016 Feb;31(2):537-41. doi: 10.1016/j.arth.2015.09.005. Epub 2015 Sep 18.
BACKGROUND
Bisphosphonates (BPs) are associated with lower total knee arthroplasty (TKA) revision risk, but the effect of bone mineral density has not been evaluated.
METHODS
A cohort of 34,116 primary TKA patients was evaluated with revision surgery and periprosthetic fractures as end points. BP usage was the exposure of interest. Bone quality (normal, osteopenia, and osteoporosis) and patient age (<65 vs ≥65 years) were evaluated as effect modifiers of risk estimates.
RESULTS
Of the patients, 19.6% were BP users. In BP users, 0.5% underwent an aseptic revision; and 0.6%, a periprosthetic fracture. In non-BP users, 1.6% underwent aseptic revision; and 0.1%, a periprosthetic fracture.
CONCLUSION
Bisphosphonate use was associated with lower risk of revision in all bone quality categories in those older than 65 years. The risk of periprosthetic fractures was higher for patients on BP.
背景
双膦酸盐（BPs）与全膝关节置换术（TKA）翻修风险降低相关，但骨矿物质密度的影响尚未得到评估。
方法
以翻修手术和假体周围骨折为终点，对34116例初次TKA患者进行队列评估。使用双膦酸盐是感兴趣的暴露因素。骨质量（正常、骨质减少和骨质疏松）和患者年龄（<65岁与≥65岁）被评估为风险估计的效应修饰因素。
结果
患者中，19.6%使用双膦酸盐。在使用双膦酸盐的患者中，0.5%接受了无菌翻修；0.6%发生了假体周围骨折。在未使用双膦酸盐的患者中，1.6%接受了无菌翻修；0.1%发生了假体周围骨折。
结论
在65岁以上的患者中，使用双膦酸盐与所有骨质量类别中较低的翻修风险相关。使用双膦酸盐的患者发生假体周围骨折的风险更高。
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