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The risk for acute myocardial infarction increases in the weeks following total hip or total knee replacement, according to an Archives of Internal Medicine study. A commentator stresses the need for perioperative vigilance with all surgery.
Using Danish national health databases, researchers compared risks in nearly 100,000 patients undergoing joint replacement with those in matched controls not undergoing surgery. Hip replacement carried a 25-fold increased risk for MI relative to controls in the first 2 weeks after surgery, returning to background values after 6 weeks. For knee replacement, the risk was 30-fold higher by 2 weeks, and then dropped rapidly.
A commentator urges physicians to "actively work to reduce perioperative risk."