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Total joint replacement patients face increased future risk of needing second procedure: 4 study insights

A study published in The Journal of Bone and Joint Surgery examined the rate of patients undergoing total joint replacement who subsequently needed an additional total joint replacement procedure.

Thomas Sanders, MD, a Rochester, Minn.-based Mayo Clinic orthopedic surgeon, and colleagues conducted a cohort study of patients who underwent either total hip or total knee arthroplasty. Researchers identified 1,933 total hip patients and 2,139 total knee patients.

Here's what they found.

1. At a 12-year mean follow-up following initial total hip arthroplasty, researchers observed 422 contralateral total hip arthroplasties, 76 contralateral TKA and 32 ipsilateral total knee arthroplasties.

2. Younger age was a predictor of contralateral total hip arthroplasty, but not a predictor of subsequent risk.

3. During an 11-year mean follow-up following total knee arthroplasty, researchers observed 809 contralateral total knee arthroplasties, 31 contralateral total hip arthroplasties and 29 ipsilateral total hip arthroplasties.

4. Old age was a predictor of ipsilateral or contralateral total hip arthroplasty.

Researchers concluded, "Patients undergoing total hip arthroplasty or total knee arthroplasty can be informed of a 30 percent to 45 percent chance of a surgical procedure in a contralateral cognate joint and about a 5 percent chance of a surgical procedure in noncognate joints within 20 years of initial arthroplasty."

They attributed the increased risk of contralateral total knee replacement to changes in gait prior to or following total hip replacement. They attributed the increased risk of bilateral total hip arthroplasty in younger patients from bilateral disease processes that affect hips.

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