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March 28, 2024
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Oral bone mineral density-reducing medications may increase risk of revision TKA

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.

Osteoporosis closeup Adobe
Bone mineral density-reducing medications may increase risk of revision TKA. Image: Adobe Stock

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.