ArticleBMC musculoskeletal disorders2025
Metformin use and risk of total joint replacement in patients with diabetes: a longitudinal cohort study of Alberta's Tomorrow Project.
Article in BMC musculoskeletal disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Association of metformin with osteoarthritis progression and total joint arthroplasty: evidence from the UK Biobank, a large population-based cohort study.Clinical rheumatology · 2026Article
- Metformin use and the risk of incident immune-mediated diseases in patients with type 2 diabetes: a population-based cohort study.Frontiers in immunology · 2026Article
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5 authors.
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Abstract
purposeTo characterize the association between metformin use and risk of total joint replacement in patients with diabetes using data from Alberta's Tomorrow Project (ATP), a population-based cohort study of chronic diseases in Alberta, Canada.
methodsThe ATP participants with incidence of diabetes after enrollment were included and followed up to March 31, 2021. Metformin use, including daily doses, was measured by a time-varying approach during the follow-up. A multivariable Cox regression model was used to characterize the association between metformin use and risk of total joint replacement, after controlling for time-related variation in drug use, clinical status, BMI, lifestyles and concurrent medications.
resultsAmong 3,001 incident cases of diabetes (52% females, age at diagnosis 61.3 ± 9.5 years, average follow-up of 7.3 ± 4.7 years), the rate of total joint replacement was 7.57 per 1,000 person-year (PY) for metformin users and 9.31 per 1,000 PY for non-metformin users, with rate ratio = 0.81 (95% CI = 0.59-1.11, p-value = 0.09). In multivariable Cox regression analysis, metformin use was not significantly associated with risk of total joint replacement, with hazard ratio of 0.74 (95% CI = 0.52-1.03, p-value = 0.07) for patients with metformin medication, HR = 0.75 (95% CI = 0.46-1.22) for 0-1.0 g/day metformin use, and HR = 0.73 (95% CI = 0.49-1.08) for 1.0 + g/day use ('no metformin use' as the reference group).
conclusionsAlthough our findings are not statistically significant, our study suggests clinically a potential benefit of metformin use in reducing risk of total joint replacement in patients with diabetes.
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