Hormone Therapy May Protect Joint Replacements

Hormone replacement therapy after hip or knee replacement surgery reduced risk of prosthesis failure

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Knee and hip replacement surgeries are becoming more common as the population ages. Thus, there is a greater need to ensure these replaced joints don't fail.

A recent study found that hormone replacement therapy after a knee or hip replacement surgery significantly lowered the risk of prosthesis (artificial replacement of joint) failure.

The researchers concluded that high adherence to hormone replacement therapy and longer length of treatment were linked to a reduced risk of prosthesis failure.

"Ask your doctor about post-surgical rehab plans."

The lead author of this study was Nigel Arden from the Oxford NIHR Musculoskeletal Biomedical Research Unit in the Nuffield Department of Orthopaedics of Rheumatology and Musculoskeletal Sciences at the University of Oxford in Oxford, United Kingdom.

The study included 10,800 women in the General Practice Research Database who underwent a primary total knee or hip arthroplasty (surgical repair of a joint) between 1986 and 2006 and received a prosthesis.

Of the participants, 2,700 had used hormone replacement therapy (HRT) for at least six months, and 8,100 of the participants were matched controls (comparisons) for the HRT users.

None of the participants had a previous hip fracture or history of rheumatoid arthritis.

All participants were at least 40 years old at the time of surgery.

The researchers conducted follow-up for an average of three years after surgery.

The findings showed that the participants who used HRT for at least six months after surgery were 38 percent less likely to have prosthesis failure after surgery compared to those who did not use HRT.

The participants who used HRT for one or more years were 52 percent less likely to have prosthesis failure after surgery compared to those who did not use HRT for a year.

The researchers found that HRT before surgery did not offer any significantly reduced risk of prosthesis failure.

Participants who started taking HRT after surgery had a 76 percent decreased risk of prosthesis failure compared to participants who did not take HRT after surgery.

The findings also revealed that higher medication adherence and length of HRT use were associated with a larger reduction in the risk of prosthesis failure.

The authors noted a few limitations of their study.

First, the study was observational. Second, the study did not account for certain factors, such as bone mineral density, ethnicity and design of prosthesis or type of joint fixation. Third, there was not a placebo treatment to compare to HRT use.

This study was published on January 22 in the Annals of the Rheumatic Diseases.

The National Institute for Health Research provided funding.

Review Date: 
January 22, 2014
Last Updated:
January 23, 2014