Causes of death after hip arthroplasty in primary arthrosis

The causes of death in 1,018 patients operated on for primary osteoarthrosis with cemented total hip arthroplasty (THA) were compared with those of age- and sex-matched orthopaedic control patients and those of the general population in Finland. The mean follow-up period was 12 years for the THA patients and 11 years for the control patients. During the first 4 years after surgery, the mortality of the THA patients from circulatory diseases was significantly increased compared with that of the orthopaedic control patients; the number of deaths in patients with THA was 34 compared with 17 for orthopaedic control patients, the relative risk being 2.00 (95% confidence interval, 1.13-3.54). During the 10-year period after the surgery, the relative risk of death of the THA patients compared with the orthopaedic control patients was 1.50 for death from circulatory diseases (95% confidence intervals, 1.11-2.00), 0.42 for accidental death (95% confidence interval, 0.55-1.08), 0.74 for death from cancer, and 0.77 for death from other causes. The observed numbers of deaths from circulatory diseases or by accidents for patients with THA during a postoperative time frame of 5 to 23 years did not differ from the numbers expected for an age- and sex-matched subgroup of the Finnish population. The number of deaths from cancer was less than expected (P = .046).