Effect of timing and duration of statin exposure on risk of hip or knee revision arthroplasty: a population-based cohort study

OBJECTIVES: To determine whether the timing and also duration of statin exposure following total hip/knee arthroplasty (THA/TKA) influences the risk of revision arthroplasty. METHODS: Subjects from the Clinical Practice Research Datalink, a large population-based clinical database, who had THA/TKA from 1988-2016 were included. Propensity score adjusted Cox regression models were used to determine the association between statin exposure and the risk of revision THA/TKA, i) at any time and ii) if first exposed 0-1, 1-5, or >5 years following THA/TKA. We also investigated the effect of duration of statin exposure (<1, 1-2, 2-3, 3-4, 4-5, >5 years). RESULTS: 151,305 participants were included. 65,032 (43%) were exposed to statins during follow up and 3,500 (2.3%) had revision arthroplasty. In a propensity score adjusted model, exposure to statins was associated with a reduced risk of revision arthroplasty (HR (95%CI) 0.82 (0.75, 0.90)). Participants first exposed within 1 year and between 1 and 5 years following THA/TKA (vs unexposed) had a reduced risk of revision arthroplasty (HR (95%CI) 0.82 (0.74, 0.91) and 0.76 (0.65, 0.90), respectively). In relation to duration of statin therapy, participants exposed for more than 5 years in total (vs <1 year) had a reduced risk of revision (HR (95%CI) 0.74 (0.62, 0.88)). CONCLUSION: Statin therapy initiated up to 5 years following THA/TKA may reduce the risk of revision arthroplasty.