Effect of bisphosphonates on knee replacement surgery

Until now, no approved drug proven to alter the knee osteoarthritis (OA). At last knee replacement (KR) surgery will be the only effective therapy. Thus, there is an urgent need for new useful treatment options for knee OA. In this cohort study, the author revealed that bisphosphonates lower the risk of KR than non- bisphosphonates users.

Bone remodelling attained much attention as a therapeutic approach for treating knee osteoarthritis (OA), however, the influences of antiresorptive agents on knee OA have been contradictory, with no studies to date investigating the impacts of bisphosphonate on the clinically appropriate outcome of knee replacement (KR) surgery.

Senior women who had started bisphosphonate treatment after the diagnosis of incident knee OA were selected for the analysis. Within every one-year cohort accrual block, all bisphosphonate initiator was propensity score-matched with a non-initiator. Cox proportional hazard regression was applied to assess the impact of bisphosphonates on the risk of KR. Sensitivity analyses to direct residual confounding were also performed.

A total of 2006 bisphosphonate initiators were selected. The crude prevalence of KR was 29.1per 1000 person-years among the non-initiators and 22.0 among the initiators. Bisphosphonate initiators showed 426% lower risk of KR as compared to the non-initiators; these outcomes were comparable when additionally settled for possible confounders in the propensity score. Outcomes of sensitivity analyses supported this protective impression.

Bisphosphonate users exhibited a lower risk of KR than non-users of bisphosphonates, advising a potential advantageous impact of bisphosphonates on knee OA.