Increased Risk of Peripheral Arterial Disease After Hip Replacement

Abstract

The correlation between hip replacement (Hip-Rep) and peripheral arterial disease (PAD) remains uncertain. Thus, we investigated the relationship between Hip-Rep and risk of developing PAD in a nationwide retrospective cohort study.National Health Insurance data were used to assemble a cohort of patients who were diagnosed from 2000 to 2011. Patients with a history of PAD were excluded. A total of 5284 patients who received a Hip-Rep and 21,124 matched controls were enrolled. We used Cox proportional hazards regression model to analyze the adjusted risk of developing PAD.The risk of developing PAD in the Hip-Rep group was 1.24-fold higher (95% CI = 1.05–1.48) than that in the control group. The adjusted risk of developing PAD increased with patient age; compared with patients aged 50 years or younger, the risk among those ages at least 80 years was 4.87-fold higher. Patients with diabetes exhibited the highest risk of developing PAD (HR = 1.58, 95% CI = 1.34–1.86). Compared with patients who had not received a Hip-Rep or reported any comorbidity, patients who received a Hip-Rep were 2.45-fold more likely to develop PAD (95% CI = 1.54–3.89); the risk increased with the number of comorbidities.Hip-Reps might be independently linked with an increased risk of developing PAD. The impact of Hip-Reps on this risk was greater in women and patients ages 65 years and younger and within the first year of follow-up.

Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty

“…Though our results are statistically significant, other literature supporting this is lacking. Furthermore, as shown in previous research, a greater risk seems to be shown at 1 year revision than at 5 years [38], which contradicts the findings of this study. Concerning the lesser represented comorbidities, in THA there is a slight possibility of a relationship between increased risk of revision and metastatic cancer in the short-term, and psychoses in the medium-term, which has also been found in previous studies [13].…”

Increased Long-Term Cardiovascular Risk After Total Hip Arthroplasty

“…Hip arthroplasty has, however, been associated to peripheral arterial disease at long-term follow up. 21 This study was performed in China which implies that the association between total hip arthroplasty and vascular disease may be generalized to different regions of the world. The generalizability of the results on a global scale is further supported by the fact that the Swedish hip arthroplasty cohort differs marginally when compared with other large joint arthroplasty cohorts in the Nordic countries 22 – 24 as well as in England, 25 Australia, 26 New Zeeland, 27 and United States.…”

Risk of peripheral arterial occlusive disease in patients with rheumatoid arthritis

“…***p< 0.001. afterward. RA is a systemic inflammatory disease, with early stages of the disease leading to atherosclerotic changes (4,29,30). Georgiadis et al suggested that atherosclerotic changes in patients with RA improved after a one-year treatment of disease-modifying antirheumatic drugs (31).…”

“…If these doctors or hospitals make wrong diagnoses or coding, they will be punished with a lot of penalties. Therefore, the diagnoses and codes for acute pancreatitis and PAOD used in this study should be correct and reliable (27)(28)(29).…”