Statins and long-term risk of revision surgery after total hip arthroplasty in osteoarthritis: a multi-source data linkage study

BackgroundStatins, widely used lipid lowering drugs, have been associated with pleiotropic beneficial effects. Notably, studies conducted in vitro and in vivo suggest a link between statins and bone metabolism. Observational data in humans also hint at a decreased fracture rate among statin users. R...

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Main Authors: Andrea D'Amuri, Barbara Bordini, Mauro Pagani, Jacopo Ciaffi, Claudio D'Agostino, Alberto Di Martino, Cesare Faldini, Francesco Ursini
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Pharmacology
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Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2025.1492200/full
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author Andrea D'Amuri
Barbara Bordini
Mauro Pagani
Jacopo Ciaffi
Jacopo Ciaffi
Claudio D'Agostino
Claudio D'Agostino
Alberto Di Martino
Alberto Di Martino
Cesare Faldini
Cesare Faldini
Francesco Ursini
Francesco Ursini
author_facet Andrea D'Amuri
Barbara Bordini
Mauro Pagani
Jacopo Ciaffi
Jacopo Ciaffi
Claudio D'Agostino
Claudio D'Agostino
Alberto Di Martino
Alberto Di Martino
Cesare Faldini
Cesare Faldini
Francesco Ursini
Francesco Ursini
author_sort Andrea D'Amuri
collection DOAJ
description BackgroundStatins, widely used lipid lowering drugs, have been associated with pleiotropic beneficial effects. Notably, studies conducted in vitro and in vivo suggest a link between statins and bone metabolism. Observational data in humans also hint at a decreased fracture rate among statin users. Revision of total hip arthroplasty (THA) is a serious and costly medical event. Whether statins might influence THA failure is not clear. Aim of the current study is to assess how the preoperative use of statins may influence the risk of THA revision in patients with hip osteoarthritis (OA).MethodsWe performed a retrospective analysis of patients who underwent THA for OA in the Italian RIPO registry of Emilia-Romagna. Electronic health records were scrutinized to gather information regarding comorbidities and statin prescriptions. We employed propensity score (PS) matching to pair 1:1 statin users (SU) with statin non-users (SNU), considering factors such as age, sex, and the duration of follow-up. Survival of THA was compared between the two groups; secondary analyses were performed to ascertain the role of mortality, sex, indication for statin treatment, and statin potency or lipophilicity.Results10,927 patients were classified as SU and PS-matched with SNU. SU showed a reduced risk of THA revision over a 15-year period (adjHR 0.76, 95% CI: 0.67–0.88; p < 0.001). Notably, this observation remained consistent regardless of the indication for statin therapy or the specific characteristics of the statin medications prescribed, and it was more pronounced among male patients (adjHR 0.64, 95% CI: 0.52–0.80, p < 0.001).ConclusionOur findings suggest that statin treatment is associated with a decreased risk of long-term THA revision in patients with OA, irrespective of the original indication for statin therapy.
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spelling doaj-art-302c59df501249988a75fffa86c99d212025-08-20T02:12:19ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-04-011610.3389/fphar.2025.14922001492200Statins and long-term risk of revision surgery after total hip arthroplasty in osteoarthritis: a multi-source data linkage studyAndrea D'Amuri0Barbara Bordini1Mauro Pagani2Jacopo Ciaffi3Jacopo Ciaffi4Claudio D'Agostino5Claudio D'Agostino6Alberto Di Martino7Alberto Di Martino8Cesare Faldini9Cesare Faldini10Francesco Ursini11Francesco Ursini12Unit of Internal Medicine, Azienda Ospedaliera Carlo Poma, Mantova, ItalyLaboratory of Medical Technology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Emilia-Romagna, ItalyUnit of Internal Medicine, Azienda Ospedaliera Carlo Poma, Mantova, ItalyMedicine and Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Emilia-Romagna, ItalyDepartment of Biomedical and Neuromotor Sciences, University of Bologna, Bologna,Emilia-Romagna, ItalyDepartment of Biomedical and Neuromotor Sciences, University of Bologna, Bologna,Emilia-Romagna, Italy1st Orthopedic and Traumatology Department, IRCCS Istituto Ortopedico Rizzoli, Bologna, Emilia-Romagna, ItalyDepartment of Biomedical and Neuromotor Sciences, University of Bologna, Bologna,Emilia-Romagna, Italy1st Orthopedic and Traumatology Department, IRCCS Istituto Ortopedico Rizzoli, Bologna, Emilia-Romagna, ItalyDepartment of Biomedical and Neuromotor Sciences, University of Bologna, Bologna,Emilia-Romagna, Italy1st Orthopedic and Traumatology Department, IRCCS Istituto Ortopedico Rizzoli, Bologna, Emilia-Romagna, ItalyMedicine and Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Emilia-Romagna, ItalyDepartment of Biomedical and Neuromotor Sciences, University of Bologna, Bologna,Emilia-Romagna, ItalyBackgroundStatins, widely used lipid lowering drugs, have been associated with pleiotropic beneficial effects. Notably, studies conducted in vitro and in vivo suggest a link between statins and bone metabolism. Observational data in humans also hint at a decreased fracture rate among statin users. Revision of total hip arthroplasty (THA) is a serious and costly medical event. Whether statins might influence THA failure is not clear. Aim of the current study is to assess how the preoperative use of statins may influence the risk of THA revision in patients with hip osteoarthritis (OA).MethodsWe performed a retrospective analysis of patients who underwent THA for OA in the Italian RIPO registry of Emilia-Romagna. Electronic health records were scrutinized to gather information regarding comorbidities and statin prescriptions. We employed propensity score (PS) matching to pair 1:1 statin users (SU) with statin non-users (SNU), considering factors such as age, sex, and the duration of follow-up. Survival of THA was compared between the two groups; secondary analyses were performed to ascertain the role of mortality, sex, indication for statin treatment, and statin potency or lipophilicity.Results10,927 patients were classified as SU and PS-matched with SNU. SU showed a reduced risk of THA revision over a 15-year period (adjHR 0.76, 95% CI: 0.67–0.88; p < 0.001). Notably, this observation remained consistent regardless of the indication for statin therapy or the specific characteristics of the statin medications prescribed, and it was more pronounced among male patients (adjHR 0.64, 95% CI: 0.52–0.80, p < 0.001).ConclusionOur findings suggest that statin treatment is associated with a decreased risk of long-term THA revision in patients with OA, irrespective of the original indication for statin therapy.https://www.frontiersin.org/articles/10.3389/fphar.2025.1492200/fullosteoarthritisstatinsorthopedic surgerytotal hip arthroplastyprosthesis outcomes
spellingShingle Andrea D'Amuri
Barbara Bordini
Mauro Pagani
Jacopo Ciaffi
Jacopo Ciaffi
Claudio D'Agostino
Claudio D'Agostino
Alberto Di Martino
Alberto Di Martino
Cesare Faldini
Cesare Faldini
Francesco Ursini
Francesco Ursini
Statins and long-term risk of revision surgery after total hip arthroplasty in osteoarthritis: a multi-source data linkage study
Frontiers in Pharmacology
osteoarthritis
statins
orthopedic surgery
total hip arthroplasty
prosthesis outcomes
title Statins and long-term risk of revision surgery after total hip arthroplasty in osteoarthritis: a multi-source data linkage study
title_full Statins and long-term risk of revision surgery after total hip arthroplasty in osteoarthritis: a multi-source data linkage study
title_fullStr Statins and long-term risk of revision surgery after total hip arthroplasty in osteoarthritis: a multi-source data linkage study
title_full_unstemmed Statins and long-term risk of revision surgery after total hip arthroplasty in osteoarthritis: a multi-source data linkage study
title_short Statins and long-term risk of revision surgery after total hip arthroplasty in osteoarthritis: a multi-source data linkage study
title_sort statins and long term risk of revision surgery after total hip arthroplasty in osteoarthritis a multi source data linkage study
topic osteoarthritis
statins
orthopedic surgery
total hip arthroplasty
prosthesis outcomes
url https://www.frontiersin.org/articles/10.3389/fphar.2025.1492200/full
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