Knee and hip joint replacements are good for pain relief, improved mobility and quality of life but they may not be so good for the heart. Researchers in Boston have found that patients who had total knee or hip joint replacement surgery were at a slightly increased risk of having a heart attack during the early post-operative period.
Joint Arthroplasty a Slight Danger to Hearts
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They found that the long-term risk for a heart attack did not persist but the risk for venous blood clots in veins and lungs remained years after the procedure. The findings were published in Arthritis & Rheumatology, a journal of the American College of Rheumatology. The lead study author is Yuqing Zhang, D.Sc. Professor of Medicine and Epidemiology at Boston University School of Medicine in Boston, Massachusetts.
The study included 13, 849 patients who underwent total knee replacement surgery and 13, 849 matched controls that did not have surgery. Patients were 50 years of age or older and diagnosed with knee or hip osteoarthritis between January 2000 and December 2012.
The researchers found that 306 patients in the arthroplasty group and 286 in the non-surgical group developed myocardial infarction during the follow-up period. The risk of a heart attack was significantly higher during the first postoperative month in those who had knee replacement surgery compared to those in the non-surgical group. However, the long-term risk of a heart attack gradually declined over time.
Approximately 1.8 million arthroplasty procedures are performed worldwide each year. That number is anticipated to increase as the population ages.
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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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