A retrospective cohort study on joint replacements using the UK's General Practice Research Database (GPRD) is published in the BMJ.Researchers from Oxford looked at the records of almost 42,000 patients who had a knee or hip replacement and found that 1912 of them had bisphosphonates. They concluded,
"In patients undergoing lower limb arthroplasty, bisphosphonate use was associated with an almost twofold increase in implant survival time. These findings require replication and testing in experimental studies for confirmation."It is important to remember that this is a non-randomised study and is observational in nature. Controversy exists on how this type of data should be used and, as the researchers suggest, it requires experimental study.
With the recent news of the potential release of routine NHS data these types of observations will become more frequent. Should we act on them in the interests of improving quality or consider them hypotheses that require testing?
1. Prieto-Alhambra D, Javaid MK, Judge A, Murray D, Carr A, Cooper C, Arden NK. Association between bisphosphonate use and implant survival after primary total arthroplasty of the knee or hip: population based retrospective cohort study. BMJ 2011 Dec;343(dec06 1):d7222-d7222. Available from: http://www.bmj.com/content/343/bmj.d7222