News from AAOS: Hip & Knee Replacements Could Increase Cardiac Health in OA Patients

Hip and knee replacements have long been known to reduce pain and increase mobility in persons with moderate-to-severe arthritis. A study presented at the 2014 annual meeting of the American Academy of Orthopaedic Surgeons (AAOS, March 11-15) in New Orleans, La., also found that total joint replacement (TJR) may reduce the risk for cardiac events, including heart attack and stroke, and boost long-term survival.

Physical inactivity is a major risk factor for cardiovascular disease. Osteoarthritis (OA) is a progressive disease of the joints affecting a third of persons over the age of 65 that causes pain and limits mobility.

More recently, “there is a growing body of evidence that suggests that arthritis is associated with increased mortality secondary to cardiovascular disease, and that this risk is proportional to the degree of disability secondary to arthritis,” said Bheeshma Ravi, M.D., an orthopaedic surgeon at the University of Toronto Medical Center.

Ravi is the lead author of the study, “TJA Appears Cardioprotective in Patients with Moderate severe OA: A propensity-score Matched Landmark Analysis.”

In the study, researchers reviewed the medical data and outcomes of patients, ages 55 and older, with hip and knee arthritis between 1996 and 1998.The groups were similar in terms of age, sex, body mass index and medical comorbidities. Half of the patients received TJR and half did not.

The study found that patients who received a hip or knee replacement were more than 40 percent less likely to have a serious cardiovascular event, including a heart attack, stroke, emergent coronary revascularization or death resulting from any of the above.

The study authors concluded that TJR has a cardioprotective benefit in persons with moderate-to-severe arthritis of the hip or knee, possibly due to the increased capability for moderate physical activity (such as a brisk walk several times a week), which has “direct benefits for hypertension, obesity and diabetes, all of which are risk factors for cardiovascular disease and all of which are highly prevalent in individuals with osteoarthritis,” according to Ravi.

*The study, “TJA Appears Cardioprotective in Patients with Moderate-severe OA: A Propensity-score Matched Landmark Analysis,” was published in the Oct. 30, 2013, issue of the British Medical Journal.