Oral bone mineral density-reducing medications may increase risk of revision TKA
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Key takeaways:
- Bone mineral density-reducing medications may increase risk of revision total knee arthroplasty.
- These medications included antipsychotics, serotonin reuptake inhibitors and proton pump inhibitors.
Results showed patients who take bone mineral density-reducing medications, such as antipsychotics, serotonin reuptake inhibitors, glucocorticoids and proton pump inhibitors, may be at increased risk for revision total knee arthroplasty.
Researchers used a national administrative claims database to perform a retrospective study of data from 1,276,209 patients who underwent primary TKA between January 2010 and December 2022.
According to the study, researchers compared outcomes between patients who took at least one BMD-reducing medication within 6 months of surgery (n=502,927) vs. patients who did not take BMD-reducing medications within 6 months of surgery (n=773,282). Outcomes were assessed at 2-year postoperative follow-up and included all-cause revisions, revisions for implant loosening and revisions for periprosthetic fractures.
Compared with control patients, risk for all-cause revision at 2 years was higher among patients taking first- or second-generation antipsychotics (OR = 1.42 and 1.26, respectively), selective serotonin reuptake inhibitors (OR = 1.14), glucocorticoids (OR = 1.13) and proton pump inhibitors (OR = 1.23). In addition, second-generation antipsychotics (OR = 1.51), selective serotonin reuptake inhibitors (OR = 1.27), aromatase inhibitors (OR = 1.29) and proton pump inhibitors (OR = 1.42) were associated with increased risk of periprosthetic fracture at 2-year follow-up.
“Our findings suggest a relationship between these medications and BMD-related complications; however, further studies should seek to determine the causality of these relationships,” the researchers wrote in the study.
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