Hormone replacement therapy does not increase thrombosis risk following THA: a national database study

Area of Science:

• Orthopedic Surgery
• Thrombosis Research
• Pharmacological Risk Assessment

Background:

• Hormone replacement therapy (HRT) is known to increase venous thrombosis risk.
• The safety of HRT in patients undergoing total hip arthroplasty (THA) is not well-established.
• Current guidelines for venous thromboembolism (VTE) prophylaxis in HRT users undergoing THA are lacking.

Purpose of the Study:

• To investigate the frequency of medical and surgery-related complications in women using HRT after THA.
• To compare complication rates between HRT users and non-users following THA.

Main Methods:

• Retrospective review of a database of women aged over 40 who underwent primary THA.
• Propensity score matching to create a control group of non-HRT users.
• Comparison of 90-day medical and 1-year surgery-related complication rates, including VTE, dislocation, and revision surgery.

Main Results:

• No significant difference in deep vein thrombosis (DVT) or pulmonary embolism (PE) rates between HRT users and controls.
• HRT users had a higher likelihood of dislocation and revision surgery.
• Differences observed in postoperative anticoagulation prescribing patterns, with HRT users more likely to receive warfarin or enoxaparin and less likely to receive rivaroxaban.

Conclusions:

• HRT is not an independent risk factor for thromboembolism after THA.
• Increased rates of dislocation and revision surgery in HRT users suggest potential risks beyond VTE.
• Further research is needed to optimize perioperative management for HRT users undergoing THA.