Total hip replacement and total knee replacement have become common orthopedic surgeries. As with all surgeries, there are risks, including death. These authors looked at the number of deaths in all patients who had hip and knee replacement surgery. The same doctor in a medium-volume university hospital did all the surgeries over a period of 17 years. All patients were included, even those with serious health problems such as heart disease, kidney failure, and cancer.
Overall, there were 1718 total replacement surgeries. Seven people died within 90 days, 26 in the first year, and 56 in the first two years, for a final rate of 3.66 percent.
Out of 610 knee replacement surgeries, there were two deaths in the first 90 days, nine in the first year, and 16 in the first two years, for a rate of three percent. No deaths were directly related to the surgery.
Out of 1108 hip replacement surgeries, there were five deaths in 90 days, 18 deaths in the first year, and 40 deaths within two years, for a total rate of four percent. Only one death was directly related to the surgery.
There was no significant difference in the death rate between first-time replacement surgeries and revision surgeries.
The overall death rate was lower than the death rate for the general population of the same ages.
In all the surgeries, there were only 10 embolisms (blood clots going to the lungs), and none of them were fatal. The surgeon did not routinely use blood thinners to prevent clots. Instead, aspirin and leg compression were used. The authors note that these results may mean that blood thinners are not necessary to prevent post-surgical clotting.
Death after joint replacement surgery has been linked to several factors, such as skill of the surgeon, the number of surgeries the hospital does, patient age, and existing health risks. The authors conclude that, overall, joint replacement surgery is relatively safe in a medium-volume hospital.
Ryan M. Nunley, MD, and Paul F. Lachiewicz, MD. Mortality after Total Hip and Knee Arthroplasty in a Medium-Volume University Practice. In The Journal of Arthroplasty. April 2003. Vol. 18. No. 3. Pp. 278-285.