Will Replacement Joints Harm Your Heart?

When medication, exercise, and therapy offer little to no relief from joint pain, it may be time to consider a knee or hip replacement. Nearly two million of these surgeries are performed annually in the United States, and the number continues to rise, due to its effectiveness in helping to relieve chronic pain. Like all surgeries, though, joint replacement procedures have several downsides. Among these is an increased risk of heart attack in the weeks following surgery. If you're considering joint replacement, especially if you already have cardiovascular problems, you should weigh this risk against the benefits of a new hip or knee.

Knees, Hips, Heart: Get the Facts Before Surgery
Several studies have shown that patients who undergo major surgeries have a higher risk of heart attack during the postoperative period. At lease some of the increased risk is due to stress and a patient's worries about undergoing surgery. A 2012 study of hip and knee replacements shed more light on the link between these specific procedures and incidents of heart attack. According to researchers, you may be 25 times more likely to suffer a heart attack within two weeks of a total hip replacement; even after six weeks, the risk is still five times higher than those who do not undergone surgery. Following a total knee replacement, your risk of a heart attack is nearly 31 times higher than it would be without surgery, but after two weeks, that elevated risk seems to disappear. The increased rate of heart attacks appears to mostly affect those over age 60 with the greatest increase affecting those who are 80 years or older.

In addition to general surgery-related stresses, two other factors may influence the risk of heart attack after a joint replacement:

1) Bone marrow embolization can occur during both hip and knee replacement surgeries

2) Blood pressure and blood flow may be interrupted by factors or circumstances common during joint replacement including blood loss, fluid shifts, hypoxia, and the use of anasthesia

Managing Your Risks After Hip or Knee Replacement
The fact that your risk of heart attack may last for weeks following surgery means that you need to be extremely aware and vigilant about taking care of yourself for that extended time period. Talk with your doctor about the possibility of staying in the hospital longer or scheduling multiple post-op check ins. Ask whether blood-thinning medications, which are usually administered for a few days after surgery, should be continued to limit your risk of heart attack.

You should also take it easy. Don't about overextend yourself in the first month or two after you receive your new hip or knee. Most importantly, seek emergency help if you notice any signs of a heart attack, including chest pain, pain that radiates down your left shoulder or arm, shortness of breath, nausea, vomiting, or back or jaw pain.

Weighing the Risk of Joint Replacement
While increasing your risk of heart attack is of course a real concern, it's important to realize that undergoing a total knee or hip replacement is not as risky as other types of major surgery. Ultimately, it's important to weigh the risks of surgery against the pain and lack of mobility that often comes from advanced arthritis and other joint diseases. Most doctors recommend exhausting all non-surgical measures before you choose to undergo a hip or knee replacement. These may include:

  • Losing weight
  • Taking anti-inflammatory medications
  • Using supports such as a cane
  • Receiving cortisone injections



Lalmohamed, Arief, PharmD et. al. "Timing of Acute Myocardial Infarction in Patients Undergoing Total Hip or Knee Replacement." Archives of Internal Medicine. (2012). Web. August 15, 2012.

Pendick, Daniel. "Increase in heart attack risk after joint surgery low but persistent." Harvard Health Publications. July 30, 2012. Web. August 15, 2012.