Patients who are relieved to have that knee replacement done may have a surprise waiting for them in the future. Swedish researchers have found an increasing risk for hip and vertebral fracture in the 10 years after knee replacement. The new study was led by Cecilie Hongslo Vala, Ph.D., of the Sahlgrenska Academy in Gothenburg, Sweden. Dr. Vala told OTW, “We followed the entire Swedish population born 1902 to 1952 (n=4, 546, 820) during the period 1987 to 2002. We identified from the patient register patients with total knee replacement (TKR) due to primary osteoarthritis (n=41, 745), hip fracture (n=213, 323) and vertebral fracture (n=43, 604). We found that patients with TKR had a 42% reduced risk (hazard ratio 0.58; 95% confidence interval 0.54-0.63) of sustaining a hip fracture and 45% reduced risk (hazard ratio 0.55; 95% confidence interval 0.47-0.65) of sustaining a vertebral fracture in the 10 years period before the surgery, compared to the general population without TKR.”
“In the 10 years period after surgery patients with TKR have a 4% increased risk of sustaining hip fracture (hazard ratio 1.04; 95% confidence interval 1.00-1.09) and a 19% increased risk of vertebral fracture (hazard ratio 1.19; 95% confidence interval 1.09-1.31), compared to the general population without TKR.”
In the April 18, 2016 news release, Dr. Vala noted, “The increasing risk for hip and vertebral fracture in the 10 years after knee replacement may be explained by pain, increase of physical activity due to rehabilitation, and other biomechanical factors.”
Asked about study limitations, Dr. Vala told OTW, “The study does not include events of TKR, hip fracture or vertebral fracture before 1987 and after 2002. And we have no knowledge of comorbidity.”
