Hormone Replacement Therapy Found Protective of Hip, Knee Joint Replacements

Professor Nigel Arden Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences Botnar Research Centre Windmill Road Oxford OX3 7LD MedicalResearch.com Interview with:
Professor Nigel Arden
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences
Botnar Research Centre
Oxford OX3 7LD

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.

Citation:

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