Home › Blog › Knee Replacement Risks Just Keep Adding Up

It seems the minute I finish sharing a newly discovered knee replacement risk with you, another risk pops up just around the corner. A couple of months ago, it was a study showing knee replacement increased the risk for hip fractures. I’ve also covered extensively the risk of metal ions in the blood, ongoing pain and reliance on pain medications, heart attack and stroke, and the inability to return to expected activity levels. Here’s a knee replacement risk I haven’t yet shared—the same study that concluded an increased risk of a hip fracture following knee replacement also found an increased risk of a vertebra fracture.

What Is a Vertebra and How Does It Fracture?`

The vertebrae (one back bone is a vertebra; two or more back bones are vertebrae) are the 24 bones that form the foundation of the spinal column, which travels down the middle of the back, from the neck to the lower back. When you envision the spine, it’s these vertebrae you typically think of, but the spinal column is made up of many other structures as well: intervertebral discs, facet joints, muscles, nerves, and so on. Just like any other bone in the body, a vertebra can fracture. A vertebral fracture can be caused from anything from a severe injury, like one sustained in an automobile accident, to a weakening of aging bone, such as what occurs in osteoporosis, to everything in between.

So how do we connect point A, knee replacement, to point B, vertebral fracture? Let’s dive into the study first.

Study Shows Increase in Vertebral Fractures Following Knee Replacement

In May I covered the study mentioned above showing a 4% increased risk of hip fractures during the 10 years following knee replacement. Results of the study also showed a more disturbing increased risk for vertebral fractures in this group—a whopping 11% during the 10 years following knee replacement. This was a huge study that looked at an entire population of Swedish citizens over a 50-year period (1902–1952), and the risk for vertebral fracture before surgery was low in those who received knee replacements.

So the truth is, we don’t really know, yet, how a knee replacement increases the risk for a vertebral fracture. Further research will need to be done to connect point A to point B. Is it biomechanical, perhaps due to due the increased activity of rehabilitation after knee replacement? Is it biochemical, perhaps related to the metal ions or allergens of the knee prosthetics affecting bone in other areas of the body? Or is there some type of biological process associated with knee replacements we haven’t yet discovered? Time will tell, and with new research publishing all the time on knee replacement risks, time is likely to tell sooner rather than later.

If this isn’t enough to make you reconsider this procedure, let’s review the myriad of knee replacement risks below. This isn’t a decision you want to make without knowing what you are potentially facing following surgery.

Knee Replacement Risks Covered Before on This Blog

In case you are a new reader or just need a quick review of the previous knee replacement risks and complications I’ve covered in prior blog posts, here is a nonexhaustive list of topics and links and the general questions they answer:

• Is the knee replacement device itself safe? The knee replacement prosthesis can shed metal particles, and ions can build up in the blood.
• Do you have allergies to certain jewelry metals? If so, you have a higher risk of being allergic to knee replacement devices that contain metals.
• What if your new knee is plastic? The knee replacements made with the new plastics can also cause allergies.
• What if you have allergies but not to metals? Knee replacement risks due to the prosthetic materials aren’t reserved for those with metal allergies.
• Are there heart risks associated with knee replacement? Blood clots, heart attacks, and strokes are severe risks of knee replacement surgery.
• Will your pain go away after knee replacement? Ongoing knee pain after knee replacement is a common complaint.
• Will your pain eventually subside? Pain rates two, three, or four years following knee replacements imply a trend toward worsening rather than easing as time goes on.
• If a knee replacement is supposed to address the pain, why doesn’t it stop it, and what could cause it to get worse over time? This one is disturbing. The root cause of your knee pain could be an issue in your back. or it could even be a loose ligament, not the joint itself causing the pain.
• At least activity levels increase following knee replacement, right? Not necessarily. Only 1 in 20 knee replacement patients actually return to normal, healthy activity levels.

The upshot? Even in the world of traditional medicine, knee replacements should never be plan A. They should be the last resort. Why? Because when you cut out a joint; sever the ends of the bones that connect to it; manipulate the vessels and other structures; and drill in a metal, plastic, or ceramic prosthetic joint, there will be issues to deal with—long recovery and rehabilitation times, the stress and pain of surgery itself, complications, and so on. And the bizarre fact is, while there are some serious cases where knee replacement truly is the last resort, one-third of knee replacements aren’t even necessary. In addition, there may be nonsurgical options in regenerative medicine that can help, so for most patients there’s no reason to contemplate knee replacement risks!.

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile