The effect of hip and knee arthroplasty on oral anti-inflammatory use and the relationship to body mass index: results from the UK general practice research database


Bolland, B.J.R.F., Culliford, D.J., Maskell, J., Latham, J.M., Dunlop, D.G. and Arden, N.K. (2011) The effect of hip and knee arthroplasty on oral anti-inflammatory use and the relationship to body mass index: results from the UK general practice research database. Osteoarthritis Cartilage, 19, (1), 29-36. (doi:10.1016/j.joca.2010.10.012 ). (PMID:21034838).

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Description/Abstract

Objective: To determine the use of oral anti-inflammatory drugs in the year before and the 2 years after primary total hip (THR) or knee (TKR) replacement, and whether this varies according to Body mass Index (BMI).

Design: 28,068 THR’s and 24,364 TKR’s, with five matched controls per case were identified from the General Practitioner Research Database. Anti-inflammatory usage was categorized into “zero coverage” – no prescribed anti-inflammatory medication and “>80% coverage” – prescribed anti-inflammatory medication for greater than 80% of the days in the year. Secondary subset analysis was performed according to BMI.

Results: 1 year post-surgery the proportion of cases on >80% coverage reduced from 21% (95%confidence interval (CI): 20–22%) to 8% (95%CI: 7–10%) for THR and 21% (95%CI: 20–22%) to 13% (95%CI: 11–14%) for TKR, with no ongoing reduction at 2 years. Zero coverage increased at one and both time points. The proportion of THR’s on >80% coverage increased with BMI pre-op. The magnitude in reduction post-op was similar across all BMI groups. The proportion of TKR’s on >80% coverage pre-op was greatest in extreme BMI categories. The magnitude in reduction post-op was similar across all BMI groups.

Conclusion: THR/TKR’s reduce the need for anti-inflammatory medication with most benefit observed in the first post-operative year. Increasing BMI affects anti-inflammatory use both in the general population and those undergoing THR/TKR surgery but without strong evidence of a detrimental effect on the benefits of pain relief.

Item Type: Article
ISSNs: 1063-4584 (print)
1522-9653 (electronic)
Keywords: nsaid, hip, knee, arthroplasty
Subjects: R Medicine > RB Pathology
R Medicine > RM Therapeutics. Pharmacology
R Medicine > RS Pharmacy and materia medica
Divisions: University Structure - Pre August 2011 > School of Medicine > Developmental Origins of Health and Disease
Faculty of Medicine > Primary Care and Population Sciences
ePrint ID: 170329
Date Deposited: 05 Jan 2011 12:38
Last Modified: 16 Jun 2014 14:50
URI: http://eprints.soton.ac.uk/id/eprint/170329

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