Proton Pump Inhibitors and the Risk of Early Aseptic Loosening in Hip and Knee Arthroplasty
Introduction The use of proton pump inhibitors (PPIs) has been associated with a higher risk of osteoporotic fractures and non-unions rates. However, the relation between the use of PPIs and the development of aseptic loosening in arthroplasty procedures has not been studied. The objective of this s...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-04-01
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| Series: | Geriatric Orthopaedic Surgery & Rehabilitation |
| Online Access: | https://doi.org/10.1177/21514593221091664 |
| _version_ | 1811271676597370880 |
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| author | Iskandar Tamimi PhD Pablo Carnero MD David Bautista MD David Gonzalez MD Pablo Rodrigo MD María Jose. Bravo MD Abel Gómez MD Faleh Tamimi PhD David Garcia de Quevedo MD |
| author_facet | Iskandar Tamimi PhD Pablo Carnero MD David Bautista MD David Gonzalez MD Pablo Rodrigo MD María Jose. Bravo MD Abel Gómez MD Faleh Tamimi PhD David Garcia de Quevedo MD |
| author_sort | Iskandar Tamimi PhD |
| collection | DOAJ |
| description | Introduction The use of proton pump inhibitors (PPIs) has been associated with a higher risk of osteoporotic fractures and non-unions rates. However, the relation between the use of PPIs and the development of aseptic loosening in arthroplasty procedures has not been studied. The objective of this study is to analyze the relation between the use of PPIs, and the risk of early aseptic loosening in total knee arthroplasty (TKA) and total hip arthroplasty (THA). Materials and methods A nested case-control study was conducted on patients who were subjected THA or TKA in our center between 2010 and 2014. Cases were patients subjected to revision surgery due to early aseptic loosening during the study period. Cases were matched with controls who did not require any type of revision surgery by type of joint replacement (THA/TKA), gender, age (+/− 2 years), and follow-up time (±6 months). Odds Ratios were adjusted to potential confounders. Results The crude and adjusted ORs (95% CI) of undergoing revision surgery for aseptic loosening following primary total knee arthroplasty or total hip arthroplasty, were 6.25 (2.04–19.23) and 6.10 (1.71–21.73), respectively, for any use PPIs compared with non-users. Crude and adjusted ORs, were 11.6 (2.93–45.88) and 17.1 (2.41–121.66), respectively, for patients with a Proportion of Days Covered (PDC) for PPIs <.5 (Table 2). In addition, the crude and adjusted ORs of undergoing revision surgery, were 5.05 (1.59–16.02) and 5.01 (1.36–18.44), respectively, for patients with a PDC for PPIs ≥.5. Discussion These results suggest that PPIs should be used with caution in patients with TKA and THA, and that the use of these drugs should not be prolonged unless there was a justifiable indication. Conclusions The use of PPIs and was associated with a higher risk of early aseptic loosening in patients subjected to THA and TKA. |
| first_indexed | 2024-04-12T22:24:11Z |
| format | Article |
| id | doaj.art-8e0e9a0973bb4ea8875cfd29953c8d95 |
| institution | Directory Open Access Journal |
| issn | 2151-4593 |
| language | English |
| last_indexed | 2024-04-12T22:24:11Z |
| publishDate | 2022-04-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Geriatric Orthopaedic Surgery & Rehabilitation |
| spelling | doaj.art-8e0e9a0973bb4ea8875cfd29953c8d952022-12-22T03:14:13ZengSAGE PublishingGeriatric Orthopaedic Surgery & Rehabilitation2151-45932022-04-011310.1177/21514593221091664Proton Pump Inhibitors and the Risk of Early Aseptic Loosening in Hip and Knee ArthroplastyIskandar Tamimi PhDPablo Carnero MDDavid Bautista MDDavid Gonzalez MDPablo Rodrigo MDMaría Jose. Bravo MDAbel Gómez MDFaleh Tamimi PhDDavid Garcia de Quevedo MDIntroduction The use of proton pump inhibitors (PPIs) has been associated with a higher risk of osteoporotic fractures and non-unions rates. However, the relation between the use of PPIs and the development of aseptic loosening in arthroplasty procedures has not been studied. The objective of this study is to analyze the relation between the use of PPIs, and the risk of early aseptic loosening in total knee arthroplasty (TKA) and total hip arthroplasty (THA). Materials and methods A nested case-control study was conducted on patients who were subjected THA or TKA in our center between 2010 and 2014. Cases were patients subjected to revision surgery due to early aseptic loosening during the study period. Cases were matched with controls who did not require any type of revision surgery by type of joint replacement (THA/TKA), gender, age (+/− 2 years), and follow-up time (±6 months). Odds Ratios were adjusted to potential confounders. Results The crude and adjusted ORs (95% CI) of undergoing revision surgery for aseptic loosening following primary total knee arthroplasty or total hip arthroplasty, were 6.25 (2.04–19.23) and 6.10 (1.71–21.73), respectively, for any use PPIs compared with non-users. Crude and adjusted ORs, were 11.6 (2.93–45.88) and 17.1 (2.41–121.66), respectively, for patients with a Proportion of Days Covered (PDC) for PPIs <.5 (Table 2). In addition, the crude and adjusted ORs of undergoing revision surgery, were 5.05 (1.59–16.02) and 5.01 (1.36–18.44), respectively, for patients with a PDC for PPIs ≥.5. Discussion These results suggest that PPIs should be used with caution in patients with TKA and THA, and that the use of these drugs should not be prolonged unless there was a justifiable indication. Conclusions The use of PPIs and was associated with a higher risk of early aseptic loosening in patients subjected to THA and TKA.https://doi.org/10.1177/21514593221091664 |
| spellingShingle | Iskandar Tamimi PhD Pablo Carnero MD David Bautista MD David Gonzalez MD Pablo Rodrigo MD María Jose. Bravo MD Abel Gómez MD Faleh Tamimi PhD David Garcia de Quevedo MD Proton Pump Inhibitors and the Risk of Early Aseptic Loosening in Hip and Knee Arthroplasty Geriatric Orthopaedic Surgery & Rehabilitation |
| title | Proton Pump Inhibitors and the Risk of Early Aseptic Loosening in Hip and Knee Arthroplasty |
| title_full | Proton Pump Inhibitors and the Risk of Early Aseptic Loosening in Hip and Knee Arthroplasty |
| title_fullStr | Proton Pump Inhibitors and the Risk of Early Aseptic Loosening in Hip and Knee Arthroplasty |
| title_full_unstemmed | Proton Pump Inhibitors and the Risk of Early Aseptic Loosening in Hip and Knee Arthroplasty |
| title_short | Proton Pump Inhibitors and the Risk of Early Aseptic Loosening in Hip and Knee Arthroplasty |
| title_sort | proton pump inhibitors and the risk of early aseptic loosening in hip and knee arthroplasty |
| url | https://doi.org/10.1177/21514593221091664 |
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