Hormone Replacement Therapy Preserves Joint Implants
|
By HospiMedica International staff writers Posted on 23 Feb 2015 |
|
A new study reveals that hormone replacement therapy (HRT) is associated with an almost 40% decrease in the rate of revision surgery for hip and knee implants in women.
Researchers at the University of Oxford (United Kingdom), Universitat Autònoma de Barcelona (UAB; Spain), and other institutions conducted a study of 24,733 women who underwent primary total knee arthroplasty (TKA) or total hip arthroplasty (THA) to examine if HRT could reduce osteolysis and subsequent prosthesis loosening, the most common cause for revision surgery. The researchers explored associations with HRT use for over a year, adherence, and cumulative use and revision risk.
The results showed that the hazard ratio for implant failure fell to 0.62 after six months among HRT users. The risk reduction fell even further, reaching 0.48 for those who continued on HRT for at least a year. The results also showed that higher adherence and therapy duration were associated with further reductions in revision rates, but that preoperative HRT appeared unrelated to implant survival. The study was published in the March 2015 issue of Annals of the Rheumatic Diseases.
“Animal studies have suggested that estrogen deficiency exerts a negative influence on bone tissue around knee implants, while HRT minimizes periprosthetic bone loss and improves bone ingrowth around the implant,” concluded lead author Nigel Arden, MD, of the University of Oxford, and colleagues. “The findings that significant reductions in revision risk were seen among HRT users are encouraging for the research of antiresorptive agents that might improve outcomes following total joint replacement surgery in the future.”
The most common reason for joint replacement failure in the first year post implantation is due to aseptic loosening, which can result from osteolysis in the surrounding bone. While the mechanisms underlying loosening are still obscure, it is widely accepted that periprosthetic bone loss secondary to chronic inflammation and osteoclastic activity is the main pathway.
Related Links:
University of Oxford
Universitat Autònoma de Barcelona
Researchers at the University of Oxford (United Kingdom), Universitat Autònoma de Barcelona (UAB; Spain), and other institutions conducted a study of 24,733 women who underwent primary total knee arthroplasty (TKA) or total hip arthroplasty (THA) to examine if HRT could reduce osteolysis and subsequent prosthesis loosening, the most common cause for revision surgery. The researchers explored associations with HRT use for over a year, adherence, and cumulative use and revision risk.
The results showed that the hazard ratio for implant failure fell to 0.62 after six months among HRT users. The risk reduction fell even further, reaching 0.48 for those who continued on HRT for at least a year. The results also showed that higher adherence and therapy duration were associated with further reductions in revision rates, but that preoperative HRT appeared unrelated to implant survival. The study was published in the March 2015 issue of Annals of the Rheumatic Diseases.
“Animal studies have suggested that estrogen deficiency exerts a negative influence on bone tissue around knee implants, while HRT minimizes periprosthetic bone loss and improves bone ingrowth around the implant,” concluded lead author Nigel Arden, MD, of the University of Oxford, and colleagues. “The findings that significant reductions in revision risk were seen among HRT users are encouraging for the research of antiresorptive agents that might improve outcomes following total joint replacement surgery in the future.”
The most common reason for joint replacement failure in the first year post implantation is due to aseptic loosening, which can result from osteolysis in the surrounding bone. While the mechanisms underlying loosening are still obscure, it is widely accepted that periprosthetic bone loss secondary to chronic inflammation and osteoclastic activity is the main pathway.
Related Links:
University of Oxford
Universitat Autònoma de Barcelona
Gold Member
STI Test
Vivalytic Sexually Transmitted Infection (STI) Array
Medical Adhesive
MED 5570U
Surgical Dressing
ALLEVYN Ag+ SURGICAL
Latest Surgical Techniques News
- Injectable Foam Dressing Conforms to Deep Traumatic Wounds and Inhibits Bacteria
- Magnetically Guided Capsule Enables Targeted Small Intestine Microbiome Sampling
- New FDA-Approved Pediatric Pulmonary Valve Can Expand as Children Grow
- New Software Tools Support Precision Mapping and Guidance in Cardiac Ablation
- PSMA PET/CT Imaging Guides Treatment Selection in Recurrent Prostate Cancer
- First Surgery Using Commercial Stem Cell-Derived Heart Muscle Sheets Performed in Japan
- Tile-Based Radiation Therapy Reduces Recurrence Risk After Brain Metastasis Surgery
- Ultra-Low-Dose Radiotherapy Relieves Myeloma Bone Pain in Trial
- Labor Induction Guide Improves Patient Satisfaction in Randomized Trial
- Handheld Device Improves Targeted Cell Collection for Early Ovarian Cancer Assessment
- First Human Implant Performed With New Open Mitral Annuloplasty Ring
- FDA Approves First Sirolimus Drug-Eluting Balloon for Coronary In-Stent Restenosis
- Light-Activated Nanoparticles May Offer New Approach to Retinal Prostheses
- Handheld Infrared Imaging Device Supports Tumor Margin Assessment During Surgery
- Needle-Free Intrauterine Anesthesia Technique Reduces Pain During IUD Insertion
- Robotic Platform Advances Fetoscopic Treatment of Twin-to-Twin Transfusion Syndrome
Channels
Artificial Intelligence
view channel
AI Model Predicts Prolonged Sitting in Chronic Pelvic Pain
Chronic pelvic pain affects an estimated one in seven women and can occur with conditions such as endometriosis, adenomyosis, or uterine fibroids. Pain, fatigue, and other symptoms may contribute to prolonged... Read more
Autonomous AI Helps Streamline Urgent Skin Cancer Referrals
Urgent suspected skin cancer referrals place substantial pressure on dermatology services. In England, referrals have almost tripled since 2009, yet only about 6% lead to an urgent skin cancer diagnosis.... Read more
Critical Care
view channel
Minimally Invasive Ultrasound-Guided Procedure Eases Carpal Tunnel Symptoms
Carpal tunnel syndrome occurs when the median nerve is compressed within the wrist, causing numbness, tingling, weakness, and pain. The condition is linked to repetitive wrist and hand motion and affects... Read more
Standardized Scoring Tool Supports ICU Discharge Decisions
Intensive care unit (ICU) discharge requires clinicians to determine whether a critically ill patient can safely transfer to a lower-acuity unit. When patients deteriorate soon after transfer, “bounce-back”... Read more
Patient Care
view channel
At-Home Neuromodulation Shows Promise in Selected Patients With Hypertension
High blood pressure is a major risk factor for cardiovascular disease, including heart attack and stroke. Many patients receiving treatment for hypertension still remain above recommended blood pressure... Read more
EHR Model Flags High-Risk Periods in Patients with Metastatic Breast Cancer
Determining when patients with metastatic breast cancer are nearing the end of life remains difficult, often leading to intensive interventions with limited benefit. Prognostic uncertainty can delay goals-of-care... Read more
Medical Imaging
view channel
AI Software Detects Osteoporosis from Routine CT Scans
Osteoporosis can progress for years without pain, leaving bone loss undetected until a fracture or back pain prompts testing. By that point, bone loss may already be advanced. Bone density testing is not... Read more
AI Model Uses Pretreatment CT Scans to Predict Immunotherapy-Related Pneumonitis Risk
Pneumonitis is a potentially life-threatening form of lung inflammation that affects about 10% of patients with lung cancer receiving immunotherapy. Because it can be difficult to predict before symptoms... Read more
Health IT
view channel
Adaptive Radiation QA Software Gains Validation for NeoArc Treatments
Adaptive radiation therapy allows clinicians to adjust treatment plans to daily anatomical changes such as tumor shrinkage, weight loss, or organ movement, improving precision while limiting exposure to... Read more
Healthcare Database Helps Close Long COVID Surveillance Gap
Long COVID is a chronic condition that occurs after SARS-CoV-2 infection and lasts at least three months. It can follow severe illness, but it can also affect anyone who has been infected.... Read more
Point of Care
view channel
Continuous Glucose Monitoring Identifies Cardiometabolic Risk in Adults Without Diabetes
Dysglycemia—abnormal blood glucose regulation—can fluctuate throughout the day and often escape conventional screening. Clinicians typically rely on fasting plasma glucose and hemoglobin A1c, which offer... Read more
Microneedle Patch Enables At-Home Monitoring of Acute Kidney Injury
Kidney disease is often silent in its early stages, making timely detection difficult outside clinical settings. Early biomarkers such as neutrophil gelatinase–associated lipocalin can require blood draws... Read more
Business
view channel
World Health Expo to Showcase Trillion-Dollar Growth Across Pharma, Biotech, Longevity and Wellness at 2027 Edition
World Health Expo (WHX) expands with the new Pharma, Biotech, Longevity and Wellness industry sectors More than 235,000 professional visits, over 4,200 exhibitors and representatives from over... Read more
Medtronic Receives FDA Clearance for Vessel-Sealing Instrument for Robotic Surgery
As robotic-assisted surgery expands across U.S. hospitals, teams increasingly seek energy instruments with the familiarity and performance of tools used in open and laparoscopic procedures.... Read more
Robotic Single-Port System Gains CE Mark for Transvaginal Gynecologic Procedures
Intuitive (Sunnyvale, CA, USA) announced that it has received CE mark approval for use of the da Vinci SP Single Port surgical system in transvaginal gynecologic procedures, marking the first such indication... Read more