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The relation between total joint arthroplasty and risk for serious cardiovascular events in patients with moderate-severe osteoarthritis: propensity score matched landmark analysis
  1. Bheeshma Ravi1,2,3,
  2. Ruth Croxford4,
  3. Peter C Austin2,4,
  4. Lorraine Lipscombe2,3,5,
  5. Arlene S Bierman2,4,5,6,
  6. Paula J Harvey3,5,
  7. Gillian A Hawker2,3,4,5,7
  1. 1Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Canada
  2. 2Institute of Health Policy, Management and Evaluation, University of Toronto, Canada
  3. 3Women's College Research Institute, Women's College Hospital, Toronto, Canada
  4. 4Institute for Clinical Evaluative Sciences, Toronto, Canada
  5. 5Department of Medicine, University of Toronto, Canada
  6. 6Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Canada
  7. 7Division of Rheumatology, Department of Medicine, Women's College Hospital, Toronto, Canada
  1. Correspondence to : B Ravi, Women's College Hospital, 76 Grenville Street, 6th Floor, Room 6327, Toronto, ON M5S 1B2, Canada; bheeshma.ravi{at}


STUDY QUESTION What are the rates of serious cardiovascular events in those who undergo primary total joint arthroplasty (TJA) compared with those who do not within three years of initial assessment?

SUMMARY ANSWER Undergoing elective primary TJA within three years of initial assessment was associated with a significant 12.4% absolute reduction in subsequent risk of serious cardiovascular events.

WHAT IS KNOWN AND WHAT THIS PAPER ADDS Osteoarthritis is associated with increased mortality, particularly secondary to cardiovascular disease, with the risk for mortality proportional to the degree of disability secondary to the arthritis. This study suggests that management of hip or knee osteoarthritis with arthroplasty decreases the risk for subsequent serious cardiovascular events.

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