Most joint replacement surgeries involve the hip or knee. Nearly one million total joint replacements are performed in the U.S. each year. Of these, approximately 30,000 are complicated by postoperative cardiac events such as heart attacks and irregular heart rhythms.

Researchers identified 209 patients who received an initial or a second total joint replacement (TJR) of the knee or hip at one institution over a three year period and had cardiac complications during their admission—including heart attack, congestive heart failure, unstable angina, irregular heartbeat, or pulmonary embolism. These patients with complications were compared with patients who did not have complications following their TJR.

After reviewing medical records, researchers documented two newly identified risk factors for cardiac complications: bilateral surgery (having both joints replaced during the same procedure) and revision surgery (removing prosthesis, or replaced joint, and replacing it with a new one, often due to a break, infection or loosening of the original prosthesis). In addition, older age and a history of cardiac problems were associated with cardiac problems following surgery, two risks that were previously known.

“Orthopedic procedures such as total joint replacement are generally safe, with few complications,” said Jeffrey N. Katz, MD; MSc; director, Orthopedics and Arthritis Center for Outcomes Research; Brigham and Women's Hospital associate professor of orthopaedics and physician researcher; Harvard Medical School. “Physicians caring for total joint replacement patients should be aware that those who have bilateral or revision surgery and those with cardiac histories, along with the elderly, are at higher risk and merit closer observation for cardiac complications.”

COMPAMED.de; Source: American College of Rheumatology