Postvaccination immune responses and risk of primary total hip arthroplasty-A population-based cohort study

Sonia Rojewski; Marianne Westberg; Lars Nordsletten; Haakon E Meyer; Kristin Holvik; Ove Furnes; Anne Marie Fenstad; Jesper Dahl

doi:10.1016/j.joca.2023.05.007

Postvaccination immune responses and risk of primary total hip arthroplasty-A population-based cohort study

Osteoarthritis Cartilage. 2023 Sep;31(9):1249-1256. doi: 10.1016/j.joca.2023.05.007. Epub 2023 May 24.

Authors

Sonia Rojewski¹, Marianne Westberg², Lars Nordsletten³, Haakon E Meyer⁴, Kristin Holvik⁵, Ove Furnes⁶, Anne Marie Fenstad⁷, Jesper Dahl⁸

Affiliations

¹ Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway. Electronic address: sonroj@ous-hf.no.
² Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway. Electronic address: uxartb@ous-hf.no.
³ Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway. Electronic address: lars.nordsletten@medisin.uio.no.
⁴ Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway; Department of Community Medicine and Global Health, University of Oslo, Oslo, Norway. Electronic address: haakoneduard.meyer@fhi.no.
⁵ Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway. Electronic address: kristin.holvik@fhi.no.
⁶ Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway; Norwegian Arthroplasty Register, Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway. Electronic address: ove.nord.furnes@helse-bergen.no.
⁷ Norwegian Arthroplasty Register, Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway. Electronic address: anne.marie.fenstad@helse-bergen.no.
⁸ Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway. Electronic address: jesper.dahl@fhi.no.

PMID: 37236299
DOI: 10.1016/j.joca.2023.05.007

Abstract

Objective: To investigate the relationship between individual postvaccination immune responses and subsequent risk of total hip arthroplasty (THA) due to idiopathic osteoarthritis (OA) or rheumatoid arthritis (RA).

Method: Results of tuberculin skin tests (TSTs) following the Bacille Calmette-Guerin (BCG) vaccination were used as a marker of individual immune responses. TST results from the mandatory mass tuberculosis screening program 1948-1975 (n = 236 770) were linked with information on subsequent THA during 1987-2020 from the Norwegian Arthroplasty Register. The multivariable Cox proportional hazard regression was performed.

Results: A total of 10 698 individuals received a THA during follow-up. In men, there was no association between TST and risk of THA due to OA (Hazard ratio [HR] 1.01, 95% confidence interval [CI] 0.92-1.12 for positive versus negative TST and HR 1.06, 95% CI 0.95-1.18 for strong positive vs negative TST), while the risk estimates increased with increasingly restrictive sensitivity analyses. In women, there was no association with THA due to OA for positive versus negative TST (HR 0.98, 95% CI 0.92-1.05), while a strong positive TST was associated with reduced risk of THA (HR 0.90, 95% CI 0.84-0.97). No significant associations were observed in the sensitivity analysis for women or for THA due to RA.

Conclusion: Our results suggest that an increased postvaccination immune response is associated with a nonsignificant trend of increased risk of THA among men and a decreased risk among women, although risk estimates were small.

Keywords: Cartilage; Osteoarthritis; Osteoimmunology; Population-based cohort study; Rheumatology; Total hip arthroplasty.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Arthritis, Rheumatoid* / surgery
Arthroplasty, Replacement, Hip* / adverse effects
Cohort Studies
Female
Humans
Immunity
Male
Osteoarthritis, Hip* / etiology
Osteoarthritis, Hip* / surgery
Risk Factors