In the wake of all the studies demonstrating the incidence of serious risks and complications associated with hip- or knee-replacement surgery, a current study finds that men experience a much greater risk of heart attack following surgery for total hip or knee replacement.

Why would joint replacement increase the risk of heart attack? A joint-replacement surgery actually involves removing the joint and inserting a prosthesis. Completely removing a joint from a patient causes severe trauma to the blood vessels and bone-marrow space. This likely leads to a higher risk of blood clots, some of which may make it to the heart. In addition, for some patients the physical stress of undergoing the surgery may be enough to trigger a heart attack.

Researchers in a study presented at the 2015 annual meeting of the American Academy of Orthopaedic Surgeons identified 37,881 total hip-replacement patients and 59,564 total knee-replacement patients. To isolate complications related to sex, the researchers used metrics to adjust for age, provider volume, frailty, and comorbidity, and they included outcomes between 90 days to two years from surgery. The results were not surprising.  Male patients who underwent total hip-replacement surgery had a significantly greater risk of acute myocardial infarction (heart attack). Male patients who underwent total knee-replacement surgery showed a 79 percent risk of acute myocardial infarction, a 67 percent risk of deep infection, and a 49 percent risk for revision. Female patients were considered to be healthier overall, and though there was a much greater incidence of frailty, it was not accompanied by great risk of heart attack.

There always will be cases in which joint replacement is necessary. Given that research has shown one-third of knee replacements have no medical basis, and recent data has shown significant increases in the number of knee replacements being done as a result of recent changes to the healthcare system, these statistics are concerning. It is hoped that research from further studies eventually will filter down to the physicians and medical systems performing surgeries on patients who are at risk for chronic pain and heart attacks. In the meantime, being an informed patient is more important than ever.

“Men Have Greater Risk for Joint Replacement Heart Attack” first appeared as a post on the Regenexx blog.

Free Educational Seminars