Men have more major complications after hip and knee replacement than women

Men are at higher risk than women for heart attack, infection, and revision surgery after total hip or knee replacement, says a large database analysis.

Experts analysed 97,445 people in Canada who had total joint replacement. A total of 59,564 people (39% male) had knee replacement and 37,881 people (46% male) had hip replacement.
Men had more heart attacks within 90 days of having knee replacement than women (1.1% vs 0.8%), more infection within two years of surgery (1.1% vs 0.7%), and more revision knee surgery within two years (1.5% vs 1%).
Men who had total hip replacement had higher rates of early heart attack than women (0.9% vs 0.7%), but lower rates of periprosthetic fracture within two years (0.3% vs 0.5%).
The increased risk of infection and revision among men could be due to the high-impact activities that men may engage in after surgery.
“We think the potential explanations for acute MI (heart attack) after both hip and knee replacement may be additional cardiovascular risk factors,” says lead author, Prof Gillian Hawker. “We did not control for preexisting cardiovascular risk; that is something we are doing now.”