Monday, April 25, 2011

Nine-Year Incidence of Kidney Disease in Patients Who Have had Total Hip Arthroplasty.

Just published!!!!

Chandran SE, Giori NJJ Arthroplasty. 2011 Apr 18. [Epub ahead of print]
Department of Orthopedic Surgery, Stanford University, Stanford, California.


Metal-metal total hip arthroplasty (THA) is contraindicated in patients with impaired renal function due to increased metal ion output relative to other bearings and renal excretion of metal ions. Although one can avoid a metal-metal THA in a patient with renal disease, a patient may be destined to develop renal disease later in life. In this study, we sought to determine the incidence of newly diagnosed renal disease in the 9 years after THA. Using the Department of Veterans Affairs national database, we identified 1709 patients who had a primary THA in 2000 without preexisting renal disease. We found the 9-year risk of developing chronic renal disease after primary THA to be 14% and severe or end-stage renal disease to be 6%.

[Interesting study.  Here is the question. What constitutes imparted renal function?  I think there may be two ways to look at this question:
·         Does one kidney constitute impaired renal function?  Or
·         Do impaired creatinine levels alone constitute impaired renal function? (You can have normal creatinine levels in the 80’s with one kidney.)
I recall having one of my consults asking me why I had a MOM hip inserted to begin  with when I only had one kidney.  My guess is the orthopedic surgeon would say that my creatinine levels were not impaired at the time ???]

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