Cholesterol Drugs May Help Improve Hip Replacement Outcomes
New study finds post-operative statin use decreases the need for revision surgery
ROSEMONT, Ill., May 3 /PRNewswire-USNewswire/ -- The use of
statins - drugs commonly prescribed to help lower cholesterol
levels - may play an important role in decreasing complications
among patients undergoing total hip replacement (THR), according to
a study published in the May 2010 issue of The Journal of Bone and
Joint Surgery (JBJS).
"We found that use of statins substantially reduced the risk of
revision after hip replacement surgery, indicating that the
biological effects of statins may play a role in the sustainability
of hip implants," said Theis Thillemann, MD, fellow in the
department of orthopaedic surgery, Aarhus University Hospital,
Denmark.
Using records from the Danish Hip Arthroplasty Registry, a
national database of patients who had hip replacement, Dr.
Thillemann and his colleagues evaluated the effect of statin use on
the need for revision surgery and found that patients who were
taking statins for cholesterol control postoperatively had a
significantly lower risk of revision during the 10-year period
following THR. In addition, the researchers noted the risk of
revision decreased with longer use of the statins.
"In hip replacement surgery, nearly 80 percent of patients are
older than 60 years," he noted. "As a result, many of these
patients have chronic medical diseases for which they are taking
medicine. Although it's recognized that many of these drugs affect
bone metabolism, currently there is limited information on the
implications of other medical treatments on implant survival after
THR."
"The survival of a hip implant is related to many different
mechanisms," Dr. Thillemann noted. "Statins have been associated
with improved bone metabolism, improved anti-inflammatory effects
and improved prognosis after infections," added Dr.
Thillemann.
Because statins are so widely used in older individuals, the
same population that is most likely to undergo total hip
replacement, Dr. Thillemann said studying the effects of the drugs
on THR patients was a logical step.
Dr. Thillemann noted that these drugs may help to improve THR
outcomes in several ways, including to:
-- encourage bone formation, which may improve the fixation of the
implant to the bone;
-- reduce inflammation, which can cause the implant to become loose
-- reduce the rate of infections at the site of the implant.
While this study evaluated the post-operative use of statins in
patients who were taking the drugs primarily for a cardiovascular
condition, Dr. Thillemann said future research will help determine
whether statins should be prescribed prior to THR in otherwise
healthy patients, as well as to determine optimum dosing
regimens.
Dr. Thillemann added, any general recommendation of statin use
in THR patients depends on several factors, including the:
-- association between statin use and the risk of revision;
-- effect and safety of statin therapy on other existing medical
conditions
-- price of statin therapy.
"For the clinician, it is important to know that statins may
improve longevity of hip replacements," Dr. Thillemann noted. "In
our research group, we continue to our look into the role of
statins in the prognosis of hip implants, both in clinical and
experimental study designs. Ideally, further studies will confirm
our results and make it possible to recommend statin therapy to all
patients undergoing hip replacement surgery."
More Information: The Danish Hip Arthroplasty Registry was
established in 1995 to monitor hip replacement surgeries and their
outcomes. As part of the part of the Danish Orthopaedic Common
Database, the registry has recorded information about more than
85,000 primary total hip arthroplasties and 14,000 revisions. The
registry is maintained as part of the Affiliated Center for
Clinical Databases, Department of Clinical Epidemiology, Aarhus
University Hospital.
Disclosure: In support of their research for or preparation of
this work, one or more of the authors received, in any one year,
outside funding or grants in excess of $10,000 from the Danish
Rheumatism Association, the Augustinus Foundation, and the Korning
Foundation. Neither they nor a member of their immediate families
received payments or other benefits or a commitment or agreement to
provide such benefits from a commercial entity.
JBJS AAOS on Facebook and Twitter More information about the AAOS
Source: American Academy of Orthopaedic Surgeons
CONTACT: Lauren L. Pearson, +1-847-384-4031,
+1-708-227-1773,
pearson@aaos.org, or Lisa Meyer,
+1-847-384-4033, +1-847-942-3706,
lmeyer@aaos.org, both of American
Academy of Orthopaedic Surgeons
Web Site: http://www.aaos.org/
Posted: May 2010
