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Bisphosphonates reduce the risk of knee replacement: we need more analyses!
  1. Hui-Zi Li,
  2. Xiang-He Xu,
  3. Hua-Ding Lu
  1. Department of Orthopaedics, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
  1. Correspondence to Professor Hua-Ding Lu, Department of Orthopaedics, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China; johnniehuading{at}163.com

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With great interest, we read the recent article by Neogi et al entitled, ‘Effect of bisphosphonates on knee replacement (KR) surgery’.1 In the study, the authors concluded that in this population-based cohort of older women with incident knee osteoarthritis (OA), those with incident bisphosphonate users had lower risk of KR than non-users of bisphosphonates, which was further supported by another large cohort study.2 The strengths of this study include a propensity score-matched cohort design, Cox proportional hazards regression to control for potential confounders and sensitivity analyses focused on residual confounding. Meanwhile, the authors acknowledged the limitations of their work. We applaud and congratulate their important work for clinical practice. However, several important points should …

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