{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T08:40:25Z","timestamp":1773218425704,"version":"3.50.1"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The purpose of this study is to examine patients undergoing primary total knee arthroplasty (TKA) with and without prior history of statin use. We specifically evaluated (1) 90-day to 2-year periprosthetic fractures, (2) revisions, and (3) respective risk factors. We queried a national, all-payer database for patients undergoing primary TKA between 2010 and 2020. Chronic statin exposure was then identified and defined as more than three prescriptions filled within 1 year prior to TKA (statin users). A control cohort of patients undergoing TKA without the prior history of statin use was then created (statin na\u00efve). Cohorts were matched 1:1 based on age range, Charlson Comorbidity Index, sex, diabetes, obesity, and tobacco use, yielding 579,136 patients. Multivariate logistic regression was performed to evaluate the risk factors for periprosthetic fractures and revisions, adjusted for demographics and comorbidities. Statin users had a lower incidence of periprosthetic fractures from 90 days to 2 years compared with the statin na\u00efve (p\u2009&lt;\u20090.001). Similarly, statin users had a lower incidence of revisions at 90 days to 2 years (p\u2009&lt;\u20090.001). Using the statin-na\u00efve cohort as a reference, statin use was independently associated with decreased odds of periprosthetic fractures and revisions. Statin use was associated with a reduced risk of periprosthetic fractures and revisions. These results may mitigate postoperative risks though statin therapy is currently not recommended for fracture-related benefits alone.<\/jats:p>","DOI":"10.1055\/s-0042-1755359","type":"journal-article","created":{"date-parts":[[2022,8,9]],"date-time":"2022-08-09T23:03:40Z","timestamp":1660086220000},"page":"1259-1265","source":"Crossref","is-referenced-by-count":3,"title":["Preoperative Statin Exposure Reduces Periprosthetic Fractures and Revisions following Total Knee Arthroplasty"],"prefix":"10.1055","volume":"36","author":[{"given":"Oliver C.","family":"Sax","sequence":"additional","affiliation":[{"name":"Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandeep S.","family":"Bains","sequence":"additional","affiliation":[{"name":"Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9647-7193","authenticated-orcid":false,"given":"Zhongming","family":"Chen","sequence":"additional","affiliation":[{"name":"Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott J.","family":"Douglas","sequence":"additional","affiliation":[{"name":"Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Nace","sequence":"additional","affiliation":[{"name":"Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5651-2625","authenticated-orcid":false,"given":"Ronald E.","family":"Delanois","sequence":"additional","affiliation":[{"name":"Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,8,9]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1359\/jbmr.1998.13.4.581","article-title":"Nitrogen-containing bisphosphonates inhibit the mevalonate pathway and prevent post-translational prenylation of GTP-binding proteins, including Ras","volume":"13","author":"S P Luckman","year":"1998","journal-title":"J Bone Miner Res"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1007\/s00264-017-3551-x","article-title":"The effect of simvastatin on periprosthetic bone mineral density in the hypercholesterolaemic patients after total hip arthroplasty","volume":"42","author":"X Zhang","year":"2018","journal-title":"Int Orthop"},{"issue":"04","key":"ref3","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1359\/jbmr.2000.15.4.650","article-title":"Compactin suppresses bone resorption by inhibiting the fusion of prefusion osteoclasts and disrupting the actin ring in osteoclasts","volume":"15","author":"J T Woo","year":"2000","journal-title":"J Bone Miner Res"},{"issue":"17","key":"ref4","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.2106\/JBJS.17.01617","article-title":"Projected volume of primary total joint arthroplasty in the U.S., 2014 to 2030","volume":"100","author":"M Sloan","year":"2018","journal-title":"J Bone Joint Surg Am"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1097\/01.blo.0000214417.29335.19","article-title":"Periprosthetic fractures after total knee arthroplasties","volume":"446","author":"K I Kim","year":"2006","journal-title":"Clin Orthop Relat Res"},{"issue":"09","key":"ref6","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1097\/BOT.0b013e31816ed989","article-title":"Periprosthetic knee fractures","volume":"22","author":"J Parvizi","year":"2008","journal-title":"J Orthop Trauma"},{"issue":"03","key":"ref7","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1097\/BOT.0000000000000282","article-title":"Periprosthetic femur fractures","volume":"29","author":"W M Ricci","year":"2015","journal-title":"J Orthop Trauma"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1302\/0301-620X.98B4.37201","article-title":"Epidemiology of periprosthetic fracture of the femur in 32 644 primary total hip arthroplasties: a 40-year experience","volume":"98-B","author":"M P Abdel","year":"2016","journal-title":"Bone Joint J"},{"issue":"05","key":"ref9","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1007\/s00264-007-0364-3","article-title":"Total hip arthroplasties: what are the reasons for revision?","volume":"32","author":"S D Ulrich","year":"2008","journal-title":"Int Orthop"},{"key":"ref10","first-page":"1533","volume-title":"What are the causes of revision total knee arthroplasty in Japan? Knee","author":"Y Kasahara","year":"2013"},{"issue":"05","key":"ref11","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.2106\/JBJS.H.01805","article-title":"The risk of revision after primary total hip arthroplasty among statin users: a nationwide population-based nested case-control study","volume":"92","author":"T M Thillemann","year":"2010","journal-title":"J Bone Joint Surg Am"},{"issue":"17","key":"ref12","doi-asserted-by":"crossref","first-page":"2007","DOI":"10.1001\/archinte.165.17.2007","article-title":"Statin use and fracture risk: study of a US veterans population","volume":"165","author":"R E Scranton","year":"2005","journal-title":"Arch Intern Med"},{"issue":"01","key":"ref13","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1001\/jamacardio.2016.4700","article-title":"National trends in statin use and expenditures in the US adult population from 2002 to 2013: insights From the Medical Expenditure Panel Survey","volume":"2","author":"J A Salami","year":"2017","journal-title":"JAMA Cardiol"},{"key":"ref14","volume-title":"Projected Volume of Primary and Revision Total Joint Arthroplasty in the United States, 2030-2060","author":"M Sloan"},{"issue":"01","key":"ref15","first-page":"53","article-title":"Regulation of osteoclast differentiation by statins","volume":"3","author":"W A Grasser","year":"2003","journal-title":"J Musculoskelet Neuronal Interact"},{"issue":"11","key":"ref16","doi-asserted-by":"crossref","first-page":"605","DOI":"10.3858\/emm.2011.43.11.067","article-title":"Simvastatin inhibits osteoclast differentiation by scavenging reactive oxygen species","volume":"43","author":"H J Moon","year":"2011","journal-title":"Exp Mol Med"},{"issue":"05","key":"ref17","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1007\/s00223-007-9078-1","article-title":"A comparison between the effects of hydrophobic and hydrophilic statins on osteoclast function in vitro and ovariectomy-induced bone loss in vivo","volume":"81","author":"A Hughes","year":"2007","journal-title":"Calcif Tissue Int"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"1946","DOI":"10.1126\/science.286.5446.1946","article-title":"Stimulation of bone formation in vitro and in rodents by statins","volume":"286","author":"G Mundy","year":"1999","journal-title":"Science"},{"issue":"10","key":"ref19","doi-asserted-by":"crossref","first-page":"1636","DOI":"10.1161\/hq1001.097781","article-title":"Effect of statins on bone mineral density and bone histomorphometry in rodents","volume":"21","author":"F J Maritz","year":"2001","journal-title":"Arterioscler Thromb Vasc Biol"},{"issue":"05","key":"ref20","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1001\/archinte.162.5.537","article-title":"Statin use, bone mineral density, and fracture risk: Geelong Osteoporosis Study","volume":"162","author":"J A Pasco","year":"2002","journal-title":"Arch Intern Med"},{"key":"ref21","first-page":"1383","article-title":"Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S)","volume":"344","author":"Scandinavian Simvastatin Survival Study Group","year":"1994","journal-title":"Lancet"},{"issue":"02","key":"ref22","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1001\/jamainternmed.2014.6388","article-title":"Statin therapy and risk of fracture: results from the JUPITER randomized clinical trial","volume":"175","author":"J M Pe\u00f1a","year":"2015","journal-title":"JAMA Intern Med"}],"container-title":["The Journal of Knee Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0042-1755359.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,16]],"date-time":"2023-08-16T23:19:55Z","timestamp":1692227995000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0042-1755359"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,9]]},"references-count":22,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,8,16]]},"published-print":{"date-parts":[[2023,10]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0042-1755359","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1538-8506","1938-2480"],"issn-type":[{"value":"1538-8506","type":"print"},{"value":"1938-2480","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,9]]}}}