Massive Study Finds TKR Heightens Risk for Vertebral Fractures

In a study that covered the entire Swedish population born between 1902 and 1952 (64 to 114 years old, this year), researchers found that individuals who had had a total knee replacement (TKR) had a 4% increased risk of hip fracture and a 19% increased risk for vertebral fracture. This was compared to the population which had not had a TKR. The researchers were from Sahlgrenska Academy in Molndal, Sweden, and the study was presented at the World Congress on Osteoporosis, Osteoarthritis & Musculoskeletal Diseases.

A total of 3, 221 patients had experienced both a total knee replacement and a hip fracture. The hazard ratio (HR) for patients with knee osteoarthritis (OA) to have sustained a hip fracture during the ten years preceding their TKR was 0.58. At the end of the ten year period after their surgery it was 1.04.

The HR for patients with knee OA to have sustained a vertebral fracture during the ten years preceding TKR was 0.55 and during the ten year period after the surgery 1.19. The lower risk of hip or vertebral fracture before having a TKR and the increasing risk of hip or vertebral fracture after TKR remained after adjustment for age, gender, calendar year, and latitude. The HR for mortality the first year after TKR was 0.40 and 10 years following having a TKR it was 1.06

Lead author C. H. Vala, said, “Studies have shown that osteoarthritis is associated with higher bone mass, and, as well, there may be a decreased physical activity level due to pain. The increasing risk for hip and vertebral fracture in the 10 years after knee replacement may be explained by pain, increase of physical activity due to rehabilitation, and other biomechanical factors.”