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AuthorTamimi, Iskandar
AuthorGarcía-Meléndez, Gaspar
AuthorVieitez-Riestra, Ignacio
AuthorPalacios-Penedo, Sergio
AuthorGarceso, Diego Moriel
AuthorSanchez, Alejandro
AuthorTamimi, Faleh
AuthorGuerado, Enrique
AuthorMilner, Marc Stefan Dawid
Authorde Quevedo, David Garcia
AuthorGonzalez-Quevedo, David
Available date2024-03-13T05:14:57Z
Publication Date2023
Publication NameJournal of Bone and Joint Surgery
ResourceScopus
ISSN219355
URIhttp://dx.doi.org/10.2106/JBJS.22.01189
URIhttp://hdl.handle.net/10576/52977
AbstractBackground: Research has indicated that β-blockers may downregulate various inflammatory mediators that are involved in osteoarthritis (OA). The objective of this study was to analyze the likelihood of total knee arthroplasty (TKA) among patients with OA who were being treated with β-blockers. Methods: A nested case-control study was conducted with use of clinical records from our institutional database. We included patients who attended our outpatient clinic with a history of new-onset knee pain between 2010 and 2019. The case group included individuals who had undergone primary TKA between 2018 and 2019, whereas the control group included subjects who had not undergone TKA. Controls were matched by date of birth ±2 years, sex, calendar time (first outpatient visit ±1 year), and the grade of arthritis; the control-to-case ratio was 1:1. Adherence to β-blocker use was measured with use of the proportion of days covered (PDC) (i.e.,<0.25, ≥0.25 to <0.75, ≥0.75), and the cumulative effect was measured on the basis of the total number of years of treatment with β-blockers. A binary logistic regression analysis adjusted to potential confounders was carried out to assess the risk of TKA associated with the intake of β-blockers. Results: A total of 600 patients were included (300 in the case group and 300 in the control group). Compared with non-users, any use of β-blockers during the follow-up period was associated with a reduction in the likelihood of undergoing TKA (adjusted odds ratio [OR], 0.51; 95% confidence interval [CI], 0.34-0.77). The adjusted ORs for the use of selective β1-blockers and nonselective β1-blockers were 0.69 (95% CI, 0.36 to 1.31) and 0.42 (95% CI, 0.24 to 0.70), respectively. The adjusted ORs for any recent use, PDC of <0.25, PDC of ≥0.25 to <0.75, and PDC of ≥0.75 were 0.65 (95% CI, 0.51 to 0.99), 0.62 (95% CI, 0.21 to 1.85), 0.32 (95% CI, 0.09 to 1.22), and 0.55 (95% CI, 0.34 to 0.88), respectively. Regarding the cumulative effect of β-blockers, the adjusted ORs for the use for <1 year, ≥1 to <5 years, and ≥5 years were 0.41 (95% CI, 0.20 to 0.85), 0.52 (95% CI, 0.21 to 1.33), and 0.36 (95% CI, 0.22 to 0.60), respectively. Conclusions: The use of nonselective β-blockers was associated with a lower likelihood of undergoing TKA. Patients treated for prolonged periods were at a lower likelihood for undergoing TKA.
Languageen
PublisherLippincott Williams and Wilkins
Subjectangiotensin receptor antagonist
beta 1 adrenergic receptor blocking agent
beta adrenergic receptor blocking agent
calcium channel blocking agent
dipyrone
nonsteroid antiinflammatory agent
opiate
paracetamol
aged
anterior cruciate ligament
Article
body mass
case control study
chronic obstructive lung disease
controlled study
daily life activity
female
glaucoma
heart arrhythmia
heart failure
human
hypertension
ischemic heart disease
Kellgren-Lawrence grade
knee arthroplasty
knee function
knee radiography
major clinical study
male
osteoarthritis
patient compliance
risk factor
knee
knee osteoarthritis
knee replacement
pain
Arthroplasty, Replacement, Knee
Case-Control Studies
Humans
Knee Joint
Osteoarthritis, Knee
Pain
TitleThe Use of β-Blockers and the Risk of Undergoing a Knee Arthroplasty : A Nested Case-Control Study
TypeArticle
Pagination1494-1501
Issue Number19
Volume Number105
dc.accessType Abstract Only


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