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Joint Replacement Surgery for Osteoarthritis May Increase Your Heart Attack Risk

Cheryl Lathrop

Last updated: October 20, 2016 7:20 pm

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A recent study just published in the journal Arthritis and Rheumatology indicates that patients who undergo total hip or knee replacement surgery for osteoarthritis are at greater risk for a heart attack in the first month immediately following surgery. The study found “TKA [total knee arthroplasty] and THA [total hip arthroplasty] among osteoarthritis patients are associated with a substantially increased risk of MI [myocardial infarction, or heart attack] during the immediate postoperative period.” 1

This study collected comparative data on approximately 28,000 patients over the age of 50 with osteoarthritis — roughly 14,000 who had a total knee replacement, and the same number who didn’t have the surgery. They also collected comparative data on approximately 12,000 patients over the age of 50 with osteoarthritis — about 6,000 who had a total hip replacement, and the same number who didn’t have the surgery. 2

Researchers found that the risk of having a heart attack in the month after total knee replacement surgery was over eight times greater than for people who didn’t have the surgery; and that the risk of having a heart attack in the month after total hip replacement surgery was four times greater than for people who didn’t have the surgery. 3 Though these risks were increased during the immediate 30-day postoperative period, risk of heart attack after THA or TKA declined to no longer be significantly different between those who did or did not have their knee or hip replaced by the end of the follow-up period of the study. 4

Patients should know that any surgical procedure comes with a level of risk. And all patients should be well informed and keep an open dialogue with their physician. To help you be informed, let’s look at some of the other issues that can occur after surgery. Specifically let’s look at the FDA alerts, warnings and recalls on some joint replacement devices.

Problems After Knee Replacement

Your knee is a hinge joint between the upper leg bone (femur) and the lower leg bones (tibia and fibula). In knee replacement surgery, the ends of the damaged thigh and lower leg (shin) bones and usually the kneecap are capped with artificial surfaces lined with manmade materials.

The goals of knee replacement are to relieve pain, improve quality of life, and maintain or improve knee function. According to the Centers for Disease Control and Prevention (CDC), 719,000 total knee replacements are performed in the U.S. each year. 5

There can be problems after knee replacement. Make sure you check out the information on any device, such as FDA recalls, and talk with your doctor so you can make an informed decision about your implant.

Sometimes, you won’t be aware of an issue unless you have already had the surgery and are having trouble, which is why it is important to know if the FDA has made any announcements about medical devices that may be used during your surgery. For example, there has been a recall of a component of the Zimmer Persona Personalized Knee System knee replacement, the Persona Porous Coated, Uncemented Trabecular Metal Tibial Plate.

Complications After Hip Replacement Surgery

Your hip is a ball-and-socket joint connecting the leg to the rest of the body. Hip replacement replaces the hip joint with a prosthetic implant (artificial pieces).

The goals of hip replacement surgery include increasing mobility, improving the function of the hip joint, and relieving pain. According to the CDC, 332,000 total hip replacements are performed in the U.S. each year. 6

There can be complications after hip replacement surgery. Make sure you check out the relevant information on any devices, including recalls or FDA announcements, and talk with your doctor so you can make an informed decision. In some cases, there may have been concerns raised in medical literature about some of the devices, such as the Zimmer ProxiLock Hip Prosthesis.

In other cases, there even may have been a recall for a type of implant, such as the Stryker Rejuvenate and ABG II hip replacement.

Staying Healthy After Hip or Knee Replacement Surgery

According to the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), osteoarthritis, the most common type of arthritis, affects 27 million Americans who are over 25 years old, causing joint pain and stiffness. 7

Often, knee or hip replacement may be a good option to relieve the pain and stiffness of osteoarthritis and restore mobility in those who remain symptomatic but have tried conservative therapy, such as physical therapy. In fact, almost 1.8 million knee or hip replacement operations are performed each year worldwide. 8

In light of the findings from the recently published study that found increased risk for heart attack in the first 30 days immediately following total hip or total knee replacement, if you choose to have TKA or THA surgery, following a heart-healthy lifestyle is probably the best way to reduce the risk of a heart attack both during and after an operation. “Doctors and patients can take steps to substantially lower the risk of heart attacks by maintaining a healthy blood pressure, cholesterol level, body weight, and by exercising and not smoking,” said Gregg Fonarow, M.D., one of the study authors. 9

  1. Lu N, Misra D, Neogi T, Choi HK, Zhang Y. Total Joint Arthroplasty and the Risk of Myocardial Infarction: A General Population, Propensity Score-Matched Cohort Study. Arthritis Rheumatol. 2015 Oct;67(10):2771-2779. http://www.ncbi.nlm.nih.gov/pubmed/26331443

  2. https://www.nlm.nih.gov/medlineplus/news/fullstory_154395.html 

  3. https://www.nlm.nih.gov/medlineplus/news/fullstory_154395.html 

  4. https://www.nlm.nih.gov/medlineplus/news/fullstory_154395.html 

  5. http://www.cdc.gov/nchs/fastats/inpatient-surgery.htm 

  6. http://www.cdc.gov/nchs/fastats/inpatient-surgery.htm 

  7. https://www.nlm.nih.gov/medlineplus/news/fullstory_154395.html  

  8. https://www.nlm.nih.gov/medlineplus/news/fullstory_154395.html 

  9. https://www.nlm.nih.gov/medlineplus/news/fullstory_154395.html