Here is another reason to get that painful hip or knee replaced: it could help your heart. A study, conducted in Canada, has found that total joint replacement (TJR) reduces the risk for cardiac events such as heart attack and stroke by as much as 40%.
TJR Protects Against Cardiovascular Disease
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It is not hard to figure out why this could be the case. A lack of physical activity is a major risk factor for cardiovascular disease and osteoarthritis, which affects a third of the people over age 65, limits mobility.
Bheeshma Ravi, M.D., an orthopedic surgeon at the University of Toronto Medical Centerand the lead author of a study, said, “there is a growing body of evidence that suggests that arthritis is associated with increased mortality secondary to cardiovascular disease, and that this risk is proportional to the degree of disability secondary to arthritis.”
In the study, researchers reviewed the medical data and outcomes of patients, ages 55 and older, who had hip and knee arthritis between 1996 and 1998. The groups were similar in terms of age, sex, body mass index and medical comorbidities. Half of the patients received TJR and half did not.
The study found that patients who received a hip or knee replacement were more than 40% less likely to have a serious cardiovascular event, including a heart attack, stroke, emergent coronary revascularization or death resulting from any of the above.
The study authors concluded that TJR has a cardioprotective benefit in persons with moderate-to-severe arthritis of the hip or knee, possibly due to their increased capability for moderate physical activity. Ravi noted that moderate exercise, such a brisk walk a few times a week, has “direct benefits for hypertension, obesity and diabetes, all of which are risk factors for cardiovascular disease and all of which are highly prevalent in individuals with osteoarthritis.”
The study, “TJA Appears Cardioprotective in Patients with Moderate-severe OA: A Propensity-score Matched Landmark Analysis, ” was published in the October 30, 2013 British Medical Journal.
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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?
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.
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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