NEW ORLEANS — NSAID use can help predict the likelihood of revision total hip arthroplasty if it occurs within the first year following surgery, according to results of a study presented at the American Academy of Orthopaedic Surgeons Annual Meeting.
The researchers utilized patient data from the Catalan Joint Registry to undertake a retrospective cohort study of 11,886 patients who underwent primary total hip arthroplasty (THA) from 2005 to 2012 and excluded 4,955 patients for various reasons.
Researchers defined NSAID use via the World Health Organization ATC/DDD index into daily defined doses and further categorized into quintiles. They used multivariate models for stress ratios to account for the competing risk of death.
Factors that the researchers included in their multivariate analysis were age, gender, body mass index, alcohol use, smoking status, comorbidities, socioeconomic status and type of implant fixation used.
“There was a high level of NSAID intake in this population,” Anthony Palmer, MA, BMBCh, of Oxford, United Kingdom, said.
Results of the survival analysis showed NSAID use within the first year postoperatively was associated via survival analysis with increased incidence of revision.
“The overall revision rate was 1.1% during this time,” Palmer said.
The subdistribution hazard ratio (SHR) was 1.23 per quintile. Patients with THA in the top quintile compared to those in the lowest quintile corresponded to an adjusted SHR of 1.82. The strongest association was determined to be in males and patients greater than 72 years of age.
The researchers noted they were uncertain whether or not NSAIDs increased the risk of THA failure by impeding osteointegration.
“Therefore we performed a subgroup analysis looking at cemented vs. uncemented,” Palmer said in his presentation. “There is no difference between these two, [and] we would expect a strong association with uncemented stems, if that was the case.” – by Christian Ingram
Malak T. Paper #012. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 11-15, 2014; New Orleans.
Disclosure: Palmer has no relevant financial disclosures.