Arthroplasty today · 2026
Usage of Loop Diuretics for Hypertension is Associated With Increased Complications Following Total Hip Arthroplasty.
СтатьяНазвание и аннотация: Перевод в очереди
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Durbin Jackson W, Zhao Amy Y, Cui Eric, Kuyl Emile-Victor, Fealy Andrew W, Gill Sabrina, Das Avilash, Gu Alex, Sterling Robert, Villa Jordan C
Аннотация
BACKGROUND: Diuretics are commonly prescribed for hypertension in patients undergoing total hip arthroplasty (THA). These medications can alter bone metabolism and remodeling, yet their impact on arthroplasty outcomes remains unclear. This study aimed to evaluate the effect of diuretic use on 2-year implant-related complications following THA.
METHODS: A retrospective analysis was performed using a national administrative claims database to identify patients undergoing primary THA. Patients prescribed loop diuretics, thiazides, or combination therapy were compared to controls not taking diuretics. Multivariable logistic regression analyses were conducted to assess the association between diuretic use and 2-year outcomes, including all-cause revision, loosening, and periprosthetic fracture (PPF)-indicated revision. Odds ratios (ORs) were then recorded.
RESULTS: Of 225,996 THA patients, 61,202 (27.1%) were prescribed at least one diuretic before surgery. Multivariable analysis demonstrated higher odds of 2-year all-cause revision with thiazides (OR: 1.1), loop diuretics (OR: 1.5), and combination therapy (OR: 1.9). Loop diuretics and combination therapy were also associated with an increased risk of PPF-related revision (OR: 1.4 and 1.2, respectively). Additionally, loop diuretics were the only class associated with higher odds of revision due to mechanical loosening (OR: 1.2; P < .05 for all).
CONCLUSIONS: Loop diuretic use was associated with higher odds of adverse 2-year implant-related outcomes, including PPF, mechanical loosening, and all-cause revision. Thiazide use was also associated with a modest increase in revision risk. These findings highlight a potential relationship between diuretic use and THA outcomes; however, further studies are required to clarify causality and investigate the underlying mechanisms driving these associations.
METHODS: A retrospective analysis was performed using a national administrative claims database to identify patients undergoing primary THA. Patients prescribed loop diuretics, thiazides, or combination therapy were compared to controls not taking diuretics. Multivariable logistic regression analyses were conducted to assess the association between diuretic use and 2-year outcomes, including all-cause revision, loosening, and periprosthetic fracture (PPF)-indicated revision. Odds ratios (ORs) were then recorded.
RESULTS: Of 225,996 THA patients, 61,202 (27.1%) were prescribed at least one diuretic before surgery. Multivariable analysis demonstrated higher odds of 2-year all-cause revision with thiazides (OR: 1.1), loop diuretics (OR: 1.5), and combination therapy (OR: 1.9). Loop diuretics and combination therapy were also associated with an increased risk of PPF-related revision (OR: 1.4 and 1.2, respectively). Additionally, loop diuretics were the only class associated with higher odds of revision due to mechanical loosening (OR: 1.2; P < .05 for all).
CONCLUSIONS: Loop diuretic use was associated with higher odds of adverse 2-year implant-related outcomes, including PPF, mechanical loosening, and all-cause revision. Thiazide use was also associated with a modest increase in revision risk. These findings highlight a potential relationship between diuretic use and THA outcomes; however, further studies are required to clarify causality and investigate the underlying mechanisms driving these associations.