ArticleBMC musculoskeletal disorders2026
Postoperative bisphosphonate therapy is associated with lower prosthesis-related complications after total or reverse shoulder arthroplasty in osteoporotic patients: a TriNetX-based cohort study.
Article in BMC musculoskeletal disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesOsteoporosis is a prevalent comorbidity in patients undergoing total or reverse shoulder arthroplasty and is associated with higher rates of periprosthetic fracture, implant loosening, and revision surgery. While bisphosphonates are commonly used to treat osteoporosis, prior research has primarily examined preoperative use. This study aimed to evaluate the association between postoperative bisphosphonate initiation and implant-related complications, particularly revision surgery, in osteoporotic patients undergoing shoulder arthroplasty.
designWe used the TriNetX U.S. Collaborative Network to identify adults (≥ 18 years) with osteoporosis who underwent total shoulder arthroplasty (TSA) or reverse shoulder arthroplasty (RSA) between 2016 and 2021. Patients were categorized by postoperative bisphosphonate use, defined as initiation within one month after surgery. Propensity score matching (1:1) based on demographics and comorbidities yielded 1,489 patients per group. The primary outcome was a composite of revision surgery, periprosthetic fracture, implant loosening, and periprosthetic joint infection at 6 months. Secondary outcomes were the individual components at 6 months and 2 years. Landmark analyses evaluated the composite outcome at 30-day and 1 year postoperatively.
resultsAt 6 months, the bisphosphonate group had a lower composite complication rate compared with controls (11.0% vs. 13.4%; HR, 0.79; 95% CI, 0.63-0.98; P = 0.038), primarily driven by a lower revision rate (3.0% vs. 4.2%; HR, 0.67; 95% CI, 0.46-0.99; P = 0.041). No significant differences were observed for periprosthetic fracture, implant loosening, or infection. At 2 years, revision rates remained lower in the bisphosphonate group (7.1% vs. 8.9%; HR, 0.71; 95% CI, 0.55-0.92; P = 0.009), while other complication rates were comparable. In the landmark analysis, postoperative bisphosphonate use was associated with a lower hazard of composite implant-related complications at 1 year.
conclusionsIn this large real-world cohort, postoperative bisphosphonate initiation was associated with lower rates of composite implant-related complications and revision surgery following shoulder arthroplasty. Although causal inference cannot be established due to the observational design, these findings suggest postoperative bisphosphonate use as a potentially modifiable factor that warrants further investigation in prospective studies. LEVEL OF EVIDENCE: Level III, retrospective comparative study, treatment study.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.