Heart Problems Linked to Total Joint Replacement Surgery in Osteoarthritis

The first study of its kind examined joint replacement surgery in patients with osteoarthritis and confirmed an increased risk of cardiovascular complications.

As recently reported by MD Magazine, total knee arthroplasty (TKA) and total hip arthroplasty (THA) surgeries almost act like a time machine by providing improvements in pain levels and function. Although beneficial from that standpoint, lead author Yuqing Zhang, DSc, and colleagues aimed to determine if these procedures in patients with osteoarthritis affect heart health, particularly influencing the risk of a heart attack. The outcomes published in Arthritis & Care indicated that knee and hip replacement surgeries do indeed increase the likelihood of heart problems, however, only for a certain amount of time.

“While evidence shows that joint replacement surgery improves pain, function, and quality of life for the osteoarthritis patient, the impact of cardiovascular health has not been confirmed,” Zhang, a professor of medicine and epidemiology at Boston University School of Medicine, said in a news release.

The analysis included 13,849 patients who underwent TKA matched with another 13,849 patients who did not have the procedure. All of the participants were at least 50-years-old had been diagnosed with knee or hip osteoarthritis between January 2000 and December 2012.

During the follow-up period, a total of 306 patients who had TKA and 286 who did not had suffered a heart attack. The risk for the cardiovascular event was significantly higher during the first month with a hazard ratio (HR) of 8.75, and the likelihood declined over time. HRs varied between those who underwent THA (4.33) and those who did not (0.87). In addition, TKA and THA were linked to a significant risk for venous thromboembolism during the first month as well as over time.

“The long-term risk of heart attack was insignificant, but risk of blood clots in the lung remained for years after surgery to replace a hip or knee damaged by osteoarthritis,” Zhang confirmed.

This first general population-based study presents evidence that the risk of heart attack is significant immediately following TKA and THA surgeries — which may be something healthcare providers should keep an eye on.