Men experience greater risk of acute myocardial infarction following THA, TKA

LAS VEGAS — Following both total hip and knee arthroplasty, men had a significantly greater risk of postoperative acute myocardial infarction, as well as for deep infection and implant failure following total knee arthroplasty, according to study results presented at the American Academy of Orthopaedic Surgeons Annual Meeting.

Researchers identified 37,881 patients who underwent total hip arthroplasty (THA) and 59,564 patients who underwent total knee arthroplasty (TKA) for osteoarthritis between April 2002 and March 2009. To determine the relationship between sex and the occurrence of specific complications, the researchers used a Cox proportional hazards model censored on death and adjusted for potential confounders, including age, comorbidity, frailty and provider volume. Complications within 90 days and 2 years were included outcomes.

Bheeshma Ravi

Results showed a significantly higher rate of acute myocardial infarction and deep infection among male patients following THA, whereas rates of revision, dislocation, venous thromboembolic events and death were not different. Following TKA, although the rates of venous thromboembolic events and death were not different, the researchers found male patients had a significantly higher rate of acute myocardial infarction, deep infection, revision and mortality.

According to the Cox model, male patients undergoing THA had a significantly greater risk of acute myocardial infarction, and male patients undergoing TKA had a 79% risk of acute myocardial infarction, 67% risk of deep infection and 49% risk of revision. Overall, women tended to be healthier, even though the researchers considered a significantly greater proportion of female patients undergoing TKA or THA to be frail. – by Casey Tingle

Reference:

Ravi B, et al. Paper #595. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting. March 24-28; Las Vegas.

Disclosures: Ravi reports no relevant financial disclosures. Please see the full abstract for a complete list of all other authors’ relevant financial disclosures.