Table 1.
Characteristics of the studies included in the systematic review.
| First author, year | Study design | Inclusion/exclusion criteria | Sample size | Male, female | Mean age (yrs) | Medication type/dosage | Treatment protocol | Follow-up | Procedure | Country |
|---|---|---|---|---|---|---|---|---|---|---|
| Bass 201510 | Cohort | Inclusion Criteria: individuals ≥ 65 years of age | 394 | 136, 258 | 71.8 | Statin | Being on statin regime | 2 days | THA and TKA | United States |
| Bass 2017 | Randomized controlled trial | Inclusion Criteria: age ≥ 65 years, hip Fx surgery, or elective unilateral primary THR or TKR for osteoarthritis, life expectancy of >3 months, ability to speak English and participate in the informed consent process. Exclusion Criteria: taking a statin within the previous 30 days or intolerance of statins, pathologic hip fracture, coronary artery disease, muscle disorder, liver disease, creatinine clearance < 30 cm^3 /min, treatment with an HIV protease inhibitor, hepatitis C protease inhibitor, erythromycin, clarithromycin, niacin, or an azole antifungal agent, hip Fx patients with history of peripheral arterial disease, transient ischemic attack, or stroke | 20 | 6, 14 | 73 | Atorvastatin 40 mg daily | Hip Fx patients started study drug (atorvastatin or matched placebo) at least 4 h prior to surgery. THR and TKR patients started study drug 4 days prior to surgery. Study drug was continued until POD 45 | 90 days | THA and TKA and hip fracture surgery | United States |
| Bonano 202112 | Cohort | Exclusion criteria: revision TJA, uni compartmental TKA, and oncologic procedures | 1769 | 688, 1079 (2 missing) | 65.66 | Simvastatin 80 mg or statin | 231 received simvastatin 80 mg daily first day of procedure and continued every day of hospitalization (perioperative statin) + 572 patients were on statin regime prior to surgery (prior statin) | 90 days | THA and TKA | United States |
| Chen 2018 | Case–control | Exclusion criteria: Patients with prior arrhythmia | 46521 | 19732, 26789 | – | Statin | Statin consumption within 1 year prior to their procedure | 90 days | THA | United States |
| Cook 202014 | Cohort | Inclusion Criteria: primary THA or TKA procedure. Exclusion Criteria: age <40 years, history of hip fracture, inflammatory arthritis at the time of primary THA/TKA | 151305 | 62066, 89239 | 69.7 | Statin | Post operation and preoperation consumption of statin | 3.9 years | THA and TKA | United Kingdom |
| Dastrup 201715 | Cohort | Inclusion Criteria: primary THA patients without a history of statin use | 8370 | – | – | statin | consumption of statins during the 365 days before their primary THA | – | THA | Denmark |
| Jo 201016 | Cohort | – | 143 | 14, 129 | 69.1 | Statin | Being on regular statin therapy | 7 days | TKA | South Korea |
| Kim 201617 | Cohort | Inclusion Criteria: patients with primary unilateral TKA, a tertiary teaching hospital in Seoul, Exclusion Criteria: patients with bilateral TKA, 1 or 2 weeks apart from each other, combined operation, preoperative serum creatinine (sCr) level >1.5 mg/dl or chronic kidney disease, and with incomplete data | 1309 | 1,541,155 | 68.8 | Statin | being on regular statin therapy | 4.2 | TKA | South Korea |
| Laisalmi-kokki 201018 | Case–control | Inclusion Criteria: patients aged 50 to 84 years. Exclusion criteria: muscular, hepatic, or renal disease or insufficiency, surgery within one month of the present surgery, and, in patients with statin therapy, discontinuation of statin therapy within 48 h of surgery | 48 | 23, 25 | 70.75 | Statin | Being on regular statin therapy (mean 4 years) (statin group) | 72 h | THA and TKA | Finland |
| Lalmohamed 201619 | Cohort | Inclusion Criteria: patients with an elective primary TJR during the study period. Age >40 years with no record of hip or knee fracture in the previous 3 months, and had no history of rheumatoid arthritis | 189277 | 77421, 111856 | 69.23 | Statin | Post operation consumption of statin | 4.9 years | TJR | United Kingdom and Denmark |
| Lübbeke 201320 | Cohort | Inclusion Criteria: all primary THAs via a lateral approach and patients who had received the same uncemented cup (Morscher press fit cup) and a 28 mm head | 735 | 337, 398 | 67.8 | Statin | Any use of statins during the period between surgery and the 5-year follow-up | 5 years | THA | Switzerland |
| Oh 201822 | Cross-sectional | Inclusion Criteria: unilateral TKA under spinal anesthesia. Exclusion Criteria: incomplete medical records pertaining to statin use or general anesthesia with endotracheal intubation | 6020 | 509, 5511 | 71 | Statin | Consumption of statins from 1 month before surgery | – | TKA | South Korea |
| Oh 201921 | Cohort | Inclusion Criteria: elective TKA under spinal anesthesia. Exclusion Criteria: incomplete medical records and patients who had undergone a previous TKA, which has been reported to induce more severe pain | 1088 | 108, 980 | 71.6 | Statin | Patients who took statins (atorvastatin, rosuvastatin, simvastatin, pravastatin, pitavastatin, or fluvastatin) daily for at least 1 month before surgery and who continued to take statins from POD 0 until discharge | 3 days | TKA | South Korea |
| Pritchett 2006 | Clinical trial | Inclusion Criteria: hip and knee replacements for osteoarthritis, osteonecrosis, or osteoporosis. Exclusion Criteria: patients with any known condition associated with hyperlipidemia, other than idiopathic, use of any medication known to increase or decrease lipid concentrations, current alcoholism, and metabolic disease other than osteoporosis or osteonecrosis | 84 | 34, 50 | 71 | Statin, fish oil | Post operation consumption of statin or fish oil | Approximately less than 120 days | THA and TKA | – |
| Sutton 202124 | Cohort | Inclusion Criteria: Patients with either TKA or THA with osteoarthrosis or osteoporosis. Exclusion Criteria: trauma, fracture, or infection | 45934 | 44292, 1642 | 66.9 | Statin | Consumption of statin before surgery | 3 years | THA and TKA | United States |
| Takeshita 202025 | Cohort | Inclusion Criteria: THA due to severe hip pain. Exclusion Criteria: bilateral THA within 3 months, revision THA, and hemodialysis, and incomplete data | 203 | 34, 169 | 65.3 | Statin | Statins consumption before surgery | 7 days | THA | Japan |
| Thillemann 201026 | Case–control | Exclusion Criteria: patients could not be properly followed up. | 4698 | 2144, 2554 | – | Statin | Post operation consumption of statin | 10 years | THA | Denmark |
| Zhang 2017 | Clinical trial | Inclusion Criteria: hypercholesterolemia patients with femoral neck fracture treated by primary THA The exclusion criteria: (1) any disorder that might affect bone or mineral metabolism, (2) consumption of corticosteroids, diuretics and any agent for osteoporosis, (3) prior hip preserving surgery or revision arthroplasty. Exclusion Criteria: consumption of any lipid-lowering drugs for the past 6 months | 42 | 27, 15 | 69 | simvastatin 40 mg/day | 12 months treatment with oral administrations of simvastatin at the dosage of 40 mg/day started on the day after surgery | 12 months | THA | – |