Total Joint Replacement and the Risk of Heart Attack |

Doctors at the Harvard Medical School recently made a stunning announcement. Knee and Hip Replacements May Be Bad for the Heart

Writing in the medical journal Arthritis & Rheumatology the doctors were trying to validate the idea that  total knee arthroplasty (replacement) or total hip arthroplasty (replacement)  surgery will substantially reduce the risk of serious cardiovascular events among patients with osteoarthritis.

What they found was that among the patients who underwent knee replacement and their matched non-surgery control subjects, 306 patients and 286 control subjects developed a cardiovascular event during the followup.

During the first postoperative month, the risk of cardiovascular event was substantially increased among the knee replacement group compared with the non-knee replacement group and then gradually declined during the subsequent followup.

In analyses using venous thromboembolism as a positive control outcome, both the first month and overall hazard rating for the risk of venous thromboembolism were substantially increased in both the knee replacement and hip replacement groups.

The researchers concluded  that total knee replacement and total hip replacement among osteoarthritis patients are associated with a substantially increased risk of cardiovascular event during the immediate postoperative period. However, the overall long-term impact of these surgeries was null, unlike the risk of venous thromboembolism, which remained elevated years after patients had undergone the procedure.

Complication during knee replacement has been noted in many medical papers, in one 22 total knee replacement complications and adverse events include bleeding, wound complication, thromboembolic disease, neural deficit, vascular injury, medial collateral ligament injury, instability, malalignment, stiffness, deep joint infection, fracture, extensor mechanism disruption, patellofemoral dislocation, tibiofemoral dislocation, bearing surface wear, osteolysis, implant loosening, implant fracture/tibial insert dissociation, reoperation, revision, readmission, and death, were noted.2

1. Lu N, Misra D, Neogi T, Choi HK, Zhang Y. Total Joint Arthroplasty and the Risk of Myocardial Infarction: A General Population, Propensity Score-Matched Cohort Study. Arthritis Rheumatol. 2015 Oct;67(10):2771-9. doi: 10.1002/art.39246.2. Complications of Total Knee Arthroplasty: Standardized List and Definitions of The Knee Society.
2. Healy WL, Della Valle CJ, Iorio R, Berend KR, Cushner FD, Dalury DF, Lonner JH. Complications of Total knee arthroplasty: standardized list and definitions of the knee society. Clin Orthop Relat Res. 2012 Jul 19. [Epub ahead of print]