Knee Surgery in Older Women: Comparing Denosumab and Bisphosphonates
Author Information
Author(s): Yu Tzai-Chiu, Wu Wen-Tien, Lee Ru-Ping, Chen Ing-Ho, Wang Jen-Hung, Wen Shu-Hui, Yeh Kuang-Ting
Primary Institution: Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
Hypothesis
Does the type of osteoporosis treatment influence the incidence of total knee arthroplasty in older females with knee osteoarthritis?
Conclusion
Denosumab reduces the risk of total knee arthroplasty compared to bisphosphonates in older females with knee osteoarthritis and osteoporosis.
Supporting Evidence
- Patients treated with denosumab had a lower TKA incidence than those treated with bisphosphonates (6.9 vs. 8.5 per 1000 person-years).
- The adjusted hazard ratio for TKA in the denosumab group was 0.77, indicating a 23% reduction in risk compared to bisphosphonates.
- The most pronounced effect was observed in patients aged ≥ 80 years, with an adjusted HR of 0.39.
Takeaway
This study found that older women taking denosumab for osteoporosis had fewer knee surgeries than those taking bisphosphonates.
Methodology
The study analyzed data from the Taiwan National Health Insurance Research Database, including females aged ≥ 50 years diagnosed with knee osteoarthritis and osteoporosis who initiated treatment between 2012 and 2019.
Potential Biases
Potential for unmeasured confounding due to the retrospective nature of the study.
Limitations
The study lacked detailed sociodemographic information and certain clinical details, which may limit the interpretation of the findings.
Participant Demographics
Females aged ≥ 50 years with knee osteoarthritis and osteoporosis.
Statistical Information
P-Value
0.024
Confidence Interval
0.62–0.97
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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