A recently published article by Nigel Arden and colleagues in the Annals of Rheumatic Diseases, addressed the issue of Hormone Replacement Therapy (HRT) and its effects on joint replacement surgery. With many women beginning HRT to curb menopause symptoms, and approximately 2% of joint replacement surgeries requiring revisions, questioning the relationship between the two doesn’t seem too farfetched. When questioned by HealthDay News as to how he came to question the correlation between the two, Arden said,” 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”.
The study collected data from more than 21,000 women who had not used HRT after joint replacement surgery, and compared the results to 3,500 women who had taken HRT for at least 6 months after joint replacement surgery. The results revealed that women who took HRT were 38% less likely to need another surgery, while women who took HRT for a year or more were 50% less likely to need another surgery.
In an article by Medline Plus on the recently published results, Dr. Neil Roth, Orthopedic surgeon at Lennox Hill Hospital in New York, suggested,” there may be a role for drugs that help build and strengthen bone after knee and hip replacement surgeries”, and he added “ hormone replacement therapy might also be helpful”.
However, the article would later rouse an interesting debate. With so much literature surrounding the increased risks of heart disease and cancer with HRT, and the relatively low risk of surgical implant failure (approximately 2%), it raises the question: Is it worth it? Even Arden himself was quoted by HealthDay News as saying, “ this is only a small added benefit of hormone replacement therapy”, and Dr. Neil Roth noted, ”this study only showed an association, and not a cause-and-effect link”. However, even if the results only illustrate a correlation, and merely suggest a small benefit, the study has still shed light on a possible mechanism of joint replacement failure, and provided surgeons and clinicians with more insight into possible preventative measures in the future.
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