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High Risk Linked with Orthopedic Surgery


Jan 27, 2015
High Risk Linked with Orthopedic Surgery

Patients who have a hip or knee replaced face an increased risk of heart attack in the some weeks after the procedure, according to an international study.

Orthopedic surgery comes with a much higher risk to medical professional liability insurance companies than most medical specialties. There are always risks associated with surgery, and you need to be fully aware of those risks before making your decision to proceed with an operation. Do not hesitate to ask questions of your surgeon, anaesthetist or of other medical specialists who are managing your health in the lead up to your surgery. If you do not understand what you have been told, do not hesitate to seek clarification from us. All types of surgery carries a much higher risk of malpractice claims than do non-surgical specialties, however orthopedic surgery is at the high end of the risk range. The liability insurance companies classify orthopedic surgeons into three separate risk categories for orthopedic surgery. Proper care and planning before surgery may prevent these risks or make them less likely to occur.

Risks that may generate after hip and knee or any surgery

  1. Breathing problems after surgery. These are more common if you have had general anesthesia and a breathing tube.
  2. Heart attack or stroke during or after surgery
  3. Infection in the knee, lungs (pneumonia), or urinary tract
  4. Poor wound healing. This is more likely for people who are not healthy before surgery, people who smoke or have diabetes, or people who take medicines that weaken the immune system.
  5. An allergic reaction to any of the medicines you receive is rare, but one may occur. Some of these reactions may be life threatening.
  6. Falls in hospitals can be a major problem. The cause may be loose gowns, slippery floors, medicines that make you sleepy, pain, unfamiliar surroundings, feeling weak after surgery, or moving around with a lot of tubes attached to your body.

Increase in heart attack risk after joint surgery

Those relative risk numbers (they compare heart attack rates between people who had joint-replacement surgery and those who didn’t) could be terrifying for someone who needs to have a knee or hip replaced. The absolute risk numbers offer some reassurance. In the six weeks following surgery, one in 200 people in the study who got a new hip and one in 500 who had a knee replaced suffered a heart attack. Older patients who have a hip or knee replaced face an increased risk of heart attack in the two weeks after the procedure, according to an international study.

Researchers, whose findings appeared in the Archives of Internal Medicine, said that people having joint surgery had up to 31 times the risk of a heart attack shortly afterward. “The risk of acute myocardial infarction is substantially increased in the first 2 weeks after total hip replacement (25-fold) and total knee replacement surgery (31-fold) compared with controls,” wrote Arief Lalmohamed from Utrecht University in the Netherlands, who led the study.The link between joint surgeries and heart problems was especially high for patients aged 80 or older, they found. But those under the age of 60 weren’t at any higher risk.Although it’s not clear that the hip and knee procedures themselves triggered the heart attacks, researchers said it’s reasonable to think they would have some role.

Joint replacement carries a heart attack risk, but compared to major open surgeries, “the risk is not unusually high,” notes Dr. William Kormos, editor in chief of Harvard Men’s Health Watch. Older people have a 1% to 2% risk of dying or having a heart attack in the month after major abdominal or chest surgery. “Total hip and total knee replacement is not as risky, but is still a major operation,” Dr. Kormos says.

Death Rate After Hip, Knee Replacements

The risk of death from hip- or knee-replacement surgery has dropped substantially in recent years, a large new study finds. Dutch researchers found that since the early 1990s, death rates have fallen by almost two-thirds among Danish adults having the procedures. The length of patients’ hospital stays also dropped — from more than two weeks, on average, to about one week.The study did not dig into the reasons for the improvements, but it’s likely that changes in post-surgical care have had a big impact, said lead researcher Arief Lalmohamed, of the Utrecht Institute of Pharmaceutical Sciences in the Netherlands.

Those changes, he said, include new blood-thinning medications that help prevent patients from developing potentially dangerous blood clots after surgery. Clots can, in some cases, lead to a heart attack, stroke or pulmonary embolism (a blood clot in the lungs). In the United States, more than 1 million people have a hip or knee replacement each year, according to the U.S. National Institutes of Health. The surgery often is prompted by severe wear and tear on the joints from arthritis.

Blood clots

Blood clots can be serious complications of orthopedic surgeries like joint replacement or surgery to repair knee, hip, or other joints. Here’s how to recognize and minimize your risk of blood clots.Up to 600,000 people in the United States are affected by venous thromboembolism each year, a disease that includes deep vein thrombosis (DVT) and pulmonary embolism (PE). With DVT, a blood clot forms in a deep vein – often in the leg – and can result in serious illness, disability, and even death. A pulmonary embolism is a serious complication of DVT that occurs when part of the clot breaks up and travels through the bloodstream to the lung.

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