About 6500 of them were excluded because ...

Patients taking bisphosphonates after hip surgery or knee arthroplasty were only two times less frequently require revision procedure within five years, as patients not receiving medication, a review of British registry data found. Some 42,000 patients who underwent primary hip or knee arthroplasty from 1986 to 2006, 0. 93% of those who take bisphosphonates were revision surgery within five years compared with 1. 96% of other patients in the practice of the UK Research Database General (risk ratio 0. 54, 95% CI 0. 29 to 0. 99

P = 0. 047), said Nigel K. Arden, MD, MPH, at Oxford University in Oxford, England, and colleagues. The researchers estimate that treatment of 107 patients with joint bisphosphonates would prevent one patient from having to review, according to their online account

BMJ. Arden and his colleagues also found that bisphosphonates' apparent protective effect was somewhat stronger for knee arthroplasty compared with hip implants. The effect was more pronounced in patients with osteoarthritis, they reported. But they stopped at the recommended treatment in the program include bisphosphonates treatment. "If these results are replicated in other observational cohorts, randomized clinical trial necessary to test the efficiency and profitability using bisphosphonates before or during surgery implant to improve survival and reduce the risk of fractures," the researchers wrote. They also suggested that future research attempt to pin down subgroups of patients can get the most benefit from treatment. Because bisphosphonates inhibit bone resorption, it was suggested that they may delay or prevent bone remodeling, conducts joint lasix 40 mg iv implants in place. Arden and his colleagues noted that clinical trials were conducted with different results. None of them, however, use the following view as the main evaluation criteria. In the current study, Arden and his colleagues searched for British registry data for patients undergoing total hip or knee arthroplasty, first detection 48453. About 6500 of them were excluded because they were diagnosed with rheumatoid arthritis were younger than 40 years, or had a hip fracture procedure to replace. Slightly more than half of the remaining 41,995 are hip or knee arthroplasty. Median observation in the study was 3 years. 5 years (probable deviation 1. 6 6. 3). Overall, from 1912 patients took bisphosphonates joint with an average duration of treatment 3. '07 (Probable deviation 1. 65 to 5. 20). Median time from first appointment bisphosphonates for primary surgery was 11 years. 8 months (14. 5 months before surgery to 39. 5 months). Among those with hip joints, bisphosphonates treatment was associated with a moderate decrease in the rate of revision at some point over the next - 0. 8% compared to a user. 3% nepolzovateley. In the knee replacement group, 0. 3% of users had revision surgery at some point, compared with 1. 2% nepolzovateley. Arden and his colleagues built a model adjusted for the likelihood that the patient will be offered bisphosphonates, based on age, gender and other factors known to be associated with the use of bisphosphonates. Results: HR 0. 54 (95% .. 0 29 0 99)

knee: HR 0. 40

hip replacement (95% 0 15 7 January.).: HR 0. 64

diagnosis of osteoarthritis (95% 0 32 Jan. 28.).: HR 0. 40 (95% CI 0. 17 to 0. 93)

Researchers noted that only 11 revision procedures performed on bisphosphonates users in the study (eight hips, three knees), it was appropriate for this subgroup analysis. Other limitations included immense potential factors and the use of incomplete and possibly inaccurate registry data. In particular, data not shown lateralizatsiyi operations, so it is possible that some "changes" were actually the primary procedure on the opposite joint. But Arden and his colleagues argued that their analysis is likely to be few such errors, because the overall level of review, they estimated were similar to those observed in the more comprehensive data sets. .