MedicalResearch.com: What are the main findings of the study?
Professor Arden: We found that in a cohort of women who had used hormone replacement therapy (HRT) and underwent knee or hip replacement their risk of implant revision was reduced by about 40% compared to non-users of HRT.
MedicalResearch.com: Were any of the findings unexpected?
Professor Arden: No. HRT has milder but similar effects to bisphosphonates on bone, and we expected to find a protective effect on implant revision risk related possibly to a reduction of bone destruction (osteolysis) around the impland and consequent loosening.
MedicalResearch.com: What should clinicians and patients take away from your report?
Professor Arden: There is observational evidence that drugs used usually to prevent osteoporosis and fractures might have a beneficial effect on implant survival in patients undergoing knee or hip replacement. Randomised, placebo-controlled trials, are needed to confirm the efficacy of these medications.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Professor Arden: Randomised, placebo-controlled trials, on the effects of bone therapies on patient-reported outcomes and revision risk amongst patients undergoing knee/hip replacement are urgently needed. These might be cost-effective interventions that might improve patients’ care. We are currently working on an application for funding along these lines.
Hormone replacement therapy and mid-term implant survival following knee or hip arthroplasty for osteoarthritis: a population-based cohort study
D Prieto-Alhambra, M K Javaid, A Judge, J Maskell, C Cooper, N K Arden, on behalf of the COASt Study Group
Ann Rheum Dis annrheumdis-2013-204043Published Online First: 22 January 2014 doi:10.1136/annrheumdis-2013-204043