Beta-Blocker Use and Risk of Hip Arthroplasty in Osteoarthritis: A Retrospective Electronic Health Record Study.

OBJECTIVES

This study aimed to determine whether prior use of a beta blocker (BB) is associated with the three-year risk of total hip arthroplasty after being diagnosed with osteoarthritis of the hip and compare risks across BB subtypes.

METHODS

Through the TriNetX database, patients with hip OA were included and further divided into the with- and without-BB cohorts. BB users were defined as patients with prescriptions between 1 day and 1 year before hip OA diagnosis and at least one refill afterward. The index date was defined as the diagnosis date of hip OA. Moreover, the BB cohorts were split to evaluate the difference between different types of beta-blocking agents. After propensity score matching, a three-year risk of undergoing THA was calculated.

RESULTS

A total of 313,430 patients were involved in this study, including 23,580 with BB usage, and 289,850 without. After propensity score matching, 23,096 patients remained in each cohort. For the with- and without-BB cohort, the average ages were 69 ± 11.9 and 63.3 ± 11.4, with a majority being female (52.4% vs. 56%). After the three-year follow-up, the use of BBs (2333 vs. 1539, HR = 1.494; 95% C.I. = 1.4-1.593) was associated with a higher risk of undergoing THA. Furthermore, among the three types of BBs, the use of alpha-BBs showed the highest hazard ratio when compared to the without-BB cohort (788 vs. 470, HR = 1.639; 95% C.I. = 1.462-1.837).

CONCLUSIONS

These findings suggest a potential association between BB use and hip arthroplasty in OA patients, warranting further investigation rather than immediate changes in clinical practice. Exploration into the detailed mechanisms is warranted and merits investigation in future studies.