HealthDay News – Data from a Swedish population suggests that there is an increased risk for both hip and vertebral fractures in the 10 years following primary total knee replacement (TKR). The findings were presented at the annual meeting of the International Osteoporosis Foundation, held from April 14 to 17 in Malaga, Spain.

The new study was led by Cecilie Hongslo Vala, PhD, of the Sahlgrenska Academy in Gothenburg, Sweden, and involved the medical records of Swedes born between 1902 and 1952. According to medical records dating from 1987 to 2002, 3,221 had a TKR and a subsequent hip fracture.

Those who had total knee replacement due to osteoarthritis had a low risk of hip and spinal fractures in the decade before their TKR, the researchers said. However, after the knee replacement, their risk of hip fracture rose by 4% and their risk of spinal fracture rose 19% compared to those who did not have a TKR.

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“Studies have shown that osteoarthritis is associated with higher bone mass, and, as well, there may be a decreased physical activity level due to pain. The increasing risk for hip and vertebral fracture in the 10 years after knee replacement may be explained by pain, increase of physical activity due to rehabilitation, and other biomechanical factors,” Dr Vala said in a foundation news release.

Summary and Clinical Applicability

In a Swedish population, researchers found that individuals who underwent primary TKR for osteoarthritis had a low risk for hip and vertebral fracture in the 10 years prior to TKR.  These individuals subsequently had an increase risk of both hip and vertebral fracture in the 10 years following TKR when compared to the population without TKR.


These preliminary findings were presented in abstract form at the World Congress on Osteoporosis, Osteoarthritis, and Musculoskeletal Disease and have yet to undergo peer review prior to publication.


Vala CH, Kärrholm J, Sten S, et al. Risk for hip fracture ten years before and after total knee replacement surgery in the entire Swedish population. Abstract No. OC12.  Presented April 16, 2016 at the World Congress on Osteoporosis, Osteoarthritis, and Musculoskeletal Disease of the International Osteoporosis Foundation. Malaga, Spain.