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Home/Large Joints and Extremities/Joint Replacement Patients Risk Heart Attack
Large Joints and Extremities

Joint Replacement Patients Risk Heart Attack

September 13, 2012 1 min read Premium comments

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Joint Replacement Patients Risk Heart Attack
12-Lead EKG ST elevation tracing color coded. Source: Wikimedia Commons and public domain
Secondary

A new study coming out of Utrecht University of the Netherlands has found that, “Total hip replacement patients 60 and older were 25 times more likely to have a heart attack within the first two weeks after surgery. Those with total knee replacements had a slightly greater risk. But after six weeks, the risk returned to baseline.ʺ

The lead study author, Arief Lalmohamed, said, ʺWe learned from this study that we need to focus more on preventing cardiac outcomes following this major surgery.ʺ

According to the report in Arthritis Today Magazine the study was compiled from information gained from more than 95, 000 Danish patients who underwent total hip replacement or total knee replacement surgeries between 1998 and 2007.

The article stated, ʺThe average age of the hip patients was 72, while the average age of the knee patients was 67. The researchers found that during the two weeks immediately following each surgery, heart attack risk rose sharply—25-fold for hip patients and 31-fold for knee patients, compared with similar people in the Danish registries who did not have these surgeries.ʺ

Researchers found that after two weeks, heart attack risk dropped dramatically. Nevertheless, the overall risk of heart attack after hip replacement surgery remained elevated for six weeks. Researchers also found that the association between hip and knee replacement surgeries and heart attack was strongest in those 80 years or older.

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Discussion

14
DS
Dr. Sarah MitchellOrthopedic Surgeon · Mayo Clinic

This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?

8
JT
James Thornton, MDSpine Fellow · HSS

Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.

5
RP
R. PatelSports Medicine · Stanford

We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.

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