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Osteoarthritis Health Center

Hormone Therapy & Joint Replacement in Women

Those who took it after hip, knee replacement saw risk of second procedure drop by about 40 percent
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WebMD News from HealthDay

By Steven Reinberg

HealthDay Reporter

THURSDAY, Jan. 23, 2014 (HealthDay News) -- Women who start hormone replacement therapy after having had hip or knee replacement surgery may cut their risk of needing another procedure in the same joint by nearly 40 percent, a new study suggests.

About 2 percent of those who have a hip or knee replacement need another surgery within three years. Most of these additional procedures are needed because of a complication known as osteolysis, which happens when tiny pieces of the implant seep into the tissue around the implant, causing inflammation that destroys the bone around the implant, the British researchers explained.

"There is evidence that drugs like hormone replacement therapy, used usually to prevent osteoporosis and fractures, might have a beneficial effect on implant survival in patients undergoing knee or hip replacement," said lead researcher Dr. Nigel Arden, director of musculoskeletal epidemiology at the University of Oxford in England.

"These findings must be confirmed in further studies, but they are consistent with previous reports by our group showing an association between use of other drugs that have similar effects on bone and the risk of implant revision [surgery]," he said.

However, many women are nervous about taking hormone replacement therapy because of previously reported increased risks for heart disease and cancer. Since the risk of a second surgery is small, the question remains whether or not it's worth starting hormone replacement therapy at all.

"Indeed, this is only a small added benefit of hormone replacement therapy. However, it is a relevant piece of information for women who have received a total knee or hip replacement and are considering hormone replacement therapy for menopausal symptoms," Arden said.

The report was published online Jan. 22 in the Annals of the Rheumatic Diseases.

For the study, Arden and his colleagues collected data on more than 21,000 women who had not used hormone replacement therapy after a hip or knee replacement. The investigators compared these women with more than 3,500 women who had taken hormone replacement therapy for at least six months after surgery.

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