Hip replacements linked to strokes

An international study involving the University of Southampton has shown people who undergo a total hip replacement are at a higher risk of a stroke in the first two weeks after surgery.

The cohort study assessed about 66,000 people in the Netherlands who had total hip replacements and compared them to people who shared their age and sex, but who did not have the procedure.

Results showed patients were five times as likely to have an ischaemic stroke within the first two weeks after a total hip replacement and were four times as likely to have a haemorrhagic stroke after the same procedure.

The Clinical Excellence Commission stated hip fractures are significant injuries for anyone, but for older people it can be “catastrophic”. Many of these patients never recover fully and some die as a consequence of the fracture.

The first Australian study of hip fractures in elderly men reportedly showed there was a significant decline in physical function after surgery, with many requiring a higher level of care or transfer to supported accommodation.

In the University of Southampton study, after the first two weeks, the risk of stroke dropped steadily but remained elevated during at least the first six weeks for ischaemic stroke and the first 12 weeks for haemorrhagic stroke.

A haemorrhagic stroke is caused by bleeding in the brain and an ischemic stroke is caused by artery blockage.

Professor Cyrus Cooper Director of the Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, was lead Rheumatologist of the study and co-author of the study’s paper.

“This research has demonstrated there is a high risk of stroke to patients soon after having a total hip replacement and suggests that the use of soluble aspirin might be beneficial in reducing this risk.

“Normally we would have reservations about people taking aspirin everyday but our results suggest aspirin is a benefit and worthwhile to give to the patient before the surgery. The data is of huge clinical importance and shows the benefits of large cohort epidemiology studies,” he said.

Professor Cooper added the number of hip replacement procedures would rise as we live longer.

“These results will hopefully help healthcare professionals to provide improved services and help people who have hip replacements manage the risk of stroke after the procedure,” he said.