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Getting a New Hip or Knee? Your Heart Attack Risk Could Rise


When Los Angeles Times columnist Steve Lopez, 61, went in for knee surgery last month, he thought it was no biggie. After all, half a million older Americans this year will do the exact same thing - get a worn-out, aching knee joint replaced.

What Lopez didn't expect was to have his heart stop in the recovery room.

A quick-thinking nurse immediately started chest compressions, and Lopez is alive to write about the experience, but a new study suggests his heart problems after joint replacement surgery may not be that uncommon.

The study by Dutch researchers, published in July in the Archives of Internal Medicine, found that patients over age 60 are at a higher risk of heart attack in the first few weeks after surgery.

Patients who had a hip replacement were 31 times more likely to have a heart attack in the first two weeks after their operation. For knee-replacement patients, the risk was 25 times greater during that two-week window.

In addition, the elevated risk for heart attack remained for six weeks among the hip-replacement group, although it returned to normal levels for the knee patients after two weeks.

The researchers used data collected by the Danish government on more than 95,000 adults who had a hip or knee replaced.  They were matched to control group of adults of of the same age and gender who had not had the surgeries or any knee or hip problems.

Over the six weeks after their surgeries, one in 200 patients who had a hip replaced and one in 500 who underwent knee replacement had a heart attack, according to Reuters.

Keep in mind, however, that the overall absolute risk of heart attack during the first six weeks - even with the elevated odds - was still pretty low: only 0.51 percent for the patients in the study who had hip replacements and 0.21 percent for those who had knee replacements.

The risk was highest for those 80 or older; there was no increased risk for those under 60.

Surgery of any kind is stressful, plus blood loss and oxygen deprivation can also happen during major surgery like joint replacement, lead researcher Arief Lalmohamed from Utrecht University in the Netherlands told Reuters.

That's why it's important, he added, that patients discuss their heart history with their doctor before surgery.

In other health news:

Did you visit Yosemite this summer? Some 10,000 people who stayed in tent cabins at Yosemite National Park between June and August may be at risk for the deadly rodent-borne hantavirus, the U.S. Centers for Disease Control and Prevention said Friday. The CDC urged lab testing of patients who exhibit symptoms of the disease and recommended that doctors notify state health departments when it is found, Reuters reported.

First death from new pig flu reported. Federal health officials reported the first death, of a 61-year-old Ohio woman, from the new strain of pig flu that had sickened visitors to county fairs, according to The New York Times. The Centers for Disease Control and Prevention also conceded that there had been "limited person-to-person spread of this virus." Just three weeks ago, the agency insisted that all known cases had been caused by contact with pigs.

Boomers retiring to rural areas won't find doctors. The Associated Press reports that boomers could face difficulties finding a doctor if they retire to small towns over the next 20 years. One of the biggest problems is that Medicare pays rural doctors less per procedure than it pays urban physicians, because rural physicians' operating costs are supposedly less. That makes rural doctors less likely to accept Medicare patients. And cuts to Medicare could make the problem worse.

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