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Subscribe to this list via RSS Blog posts tagged in meta-analysis

Posted by on in Centers of Excellence
Posted on behalf of Kevin Towle

Silicone breast implants have been used for augmentation or reconstructive breast surgeries since the 1960s. However, as their popularity skyrocketed, concerns began to arise regarding a potential link between the implants and autoimmune or connective tissue diseases. Numerous studies were conducted on this issue in the 1980s and beyond, yielding mixed results. In 1992, the FDA issued a moratorium on silicone implants for safety assessment, and this ban remained in effect until 2006. Today, silicone implants are used in 84% of breast augmentation surgeries. According to the American Society of Plastic Surgeons, there were approximately 243,600 silicone breast augmentations in 2016.

During the FDA's moratorium, in 2000, a meta-analysis was conducted that examined 20 studies between 1984 and 1999. This analysis found no association between silicone breast implants and autoimmune disease. Since then, tools for autoimmune disease diagnosis have improved. Subsequent studies utilizing these tools found positive associations in previously unexamined cohorts, which demonstrated a need for an updated meta-analysis to quantitatively measure any association between silicone implants and autoimmune disease.

In 2016, Cardno ChemRisk conducted a meta-analysis of the results of 20 cohort and nine case control studies. Silicone breast implants were associated with a non-statistically significant decreased risk for all connective tissue diseases, meta-RR 0.87 (95% CI: 0.62-1.21). When stratified by disease, silicone breast implants were associated with a non-statistically significant increased risk of sclerosis, meta-RR 1.14 (0.75-1.74), and a non-statistically significant decreased risk of rheumatoid arthritis, meta-RR 0.75 (95% CI: 0.52-1.08), and systemic lupus erythematosus, meta-RR 0.90 (95% CI: 0.43-1.87). These findings suggest that silicone breast implant exposure is not associated with autoimmune disease among women.

If you would like to receive more information on this topic, please contact Dr. Andrew Monnot
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Posted by on in Centers of Excellence
Recently, our study “An assessment of gender-specific risk of implant revision following primary total hip arthroplasty: a systematic review and meta-analysis” was published in the Journal of Arthroplasty (Towle and Monnot 2016). Scientists at Cardno ChemRisk synthesized and examined the evidence on the relative risk of revision in men and women following primary total hip arthroplasty (THA). THA surgeries involve the replacement of damaged hip joints with prosthetic components in an effort to mitigate hip pain. Over time, some THA surgeries require revision due to various modes of failure, such as dislocation, infection, or aseptic loosening. A better understanding of factors that influence the risk of revision due to hip implant failure would help reduce post-surgery complications. Therefore, we performed a meta-analysis to examine if males or females are at a higher risk of revision.

Overall, findings suggested that males are at an increased risk of revision following THA when compared to females. Additionally, this study provided evidence that gender-specific risk of revision may be impacted by geographic location (i.e. United States and Europe) and time period of THA operation (i.e. post-2000). The authors discussed potential risk factors for revision among male hip implant patients, including differences in hip anatomy, degree of surgical trauma during surgery, level of physical activity following surgery, as well as differences in primary care provider interactions.

The abstract of the article is available here.  If you have any questions regarding the paper, please contact Kevin Towle or Andrew Monnot.
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