Oral Bisphosphonates May Decrease Risk for Post-Implant Revision Surgery

(HealthDay News) — For patients undergoing total joint replacement, oral bisphosphonate use is associated with a reduction in the risk of revision surgery, according to a study published in Arthritis & Rheumatology.

Daniel Prieto-Alhambra, MD, PhD, from the University of Oxford in the United Kingdom, and colleagues conducted a retrospective cohort study within Danish nationwide registries to examine the correlation between bisphosphonate use and implant survival. 

Patients aged 40 years or older undergoing total joint replacement between 1998 and 2007 were identified. Each of 1,558 bisphosphonate users was matched, using propensity scores, to up to six bisphosphonate nonusers (n=8,966).

The researchers found that during the follow-up period, 1.73% of bisphosphonate users and 4.45% of matched nonusers underwent revision surgery, at a median of 2.61 years after first surgery. Bisphosphonate users had a reduced risk for revision surgery (HR=0.41). 

Patients with the longest duration of treatment and/or the best adherence had the strongest correlation.

“Oral bisphosphonate users have a 59 percent reduced risk of revision surgery,” the researchers wrote. “This association is only present when bisphosphonates are started after arthroplasty surgery.”

Several authors disclosed financial ties to the pharmaceutical industry.


  1. Prieto-Alhambra D et al. Arthritis Rheumatol. 2014;doi:10.1002/art.38789.