A case-control study of prosthetic implants and selected chronic diseases in Medicare claims data

Ann Epidemiol. 1998 Jul;8(5):319-26. doi: 10.1016/s1047-2797(97)00212-3.


Purpose: In an exploratory case-control study of a private insurance-claims database, Greenland and Finkle (Ann Epidemiol. 1996;6:530-540) observed associations of certain prosthetic nonbreast implants with certain connective-tissue and neurologic conditions. We wished to test these associations using the same design with new data.

Methods: We examined these associations in a case-control analysis of Medicare claims data. To control for possible confounding effects of surgery, our analysis examined nonimplant surgeries of severity similar to implant surgeries.

Results: We again found associations of silicone and metal implants with connective-tissue and neurologic conditions, but we also found similar associations of carpal-tunnel surgery with those conditions.

Conclusions: Possible explanations for these findings include confounding by presurgical conditions. Therefore, we recommend further studies be done in which such conditions can be measured and controlled.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Case-Control Studies
  • Confounding Factors, Epidemiologic
  • Connective Tissue Diseases / epidemiology*
  • Connective Tissue Diseases / etiology
  • Female
  • Humans
  • Insurance Claim Review
  • Male
  • Medicare*
  • Nervous System Diseases / epidemiology*
  • Nervous System Diseases / etiology
  • Prostheses and Implants / adverse effects*
  • United States