Change the Hip, Improve the Heart

Does having a total hip or knee replacement benefit a patient’s heart? It may, according to researchers at the University of Toronto who matched 153 patients who had a joint replacement with 153 who did not. The subjects all had similar health profiles in terms of age, weight, smoking status and the severity of their arthritis. For seven years, the researchers followed both groups to record their rate of serious cardiac events, including heart attacks, heart failures and strokes.

The study author, Bheeshma Ravi, M.D., resident physician in the division of orthopedic surgery at the University of Toronto, reported, “Our study suggested that in persons with moderate to severe osteoarthritis of hip or knee, joint replacement was associated with a greater than 40% reduction in the risk for serious cardiovascular events such as heart attack and stroke.” Ravi found that with knee replacements there was a 54% reduction in heart risk. Hip replacements had a 39% reduction.

The researchers speculate on what caused the reduction in risk. Patients who had the joint replacements may have increased their physical activity, which would have been good for their hearts as well. Or patients who choose joint replacement surgery may simply be more motivated to take care of their health, suggested Trevor Murray, M.D, an orthopedic surgeon at Cleveland Clinic in Cleveland, Ohio. He told Marianne Wait of the Arthritis Foundation, “If [patients] care enough about their musculoskeletal health to go through the pain and suffering of a total joint replacement to try to get better, they’re quite possibly the same people who are trying to walk a mile-and-a-half a day and lose weight and eat appropriately, which is really hard to capture.” He pointed out that the “whole point of the surgery” is a reduction in pain.