Increased Risk of Peripheral Arterial Disease After Hip Replacement: An 11-Year Retrospective Population-Based Cohort Study

The correlation between hip replacement (Hip-Rep) and peripheral arterial disease (PAD) remains uncertain. Thus, we investigated the relationship between Hip-Rep and risk of developing PAD in a nationwide retrospective cohort study. National Health Insurance data were used to assemble a cohort of patients who were diagnosed from 2000 to 2011. Patients with a history of PAD were excluded. A total of 5284 patients who received a Hip-Rep and 21,124 matched controls were enrolled. We used Cox proportional hazards regression model to analyze the adjusted risk of developing PAD. The risk of developing PAD in the Hip-Rep group was 1.24-fold higher (95% CI = 1.05-1.48) than that in the control group. The adjusted risk of developing PAD increased with patient age; compared with patients aged 50 years or younger, the risk among those ages at least 80 years was 4.87 fold higher. Patients with diabetes exhibited the highest risk of developing PAD(HR = 1.58, 95% CI = 1.34-1.86). Compared with patients who had not received a Hip-Rep or reported any comorbidity, patients who received a Hip-Rep were 2.45-fold more likely to develop PAD (95% CI = 1.543.89); the risk increased with the number of comorbidities. Hip-Reps might be independently linked with an increased risk of developing PAD. The impact of Hip-Repson this risk was greater in women and patients ages 65 years and younger and within the first year of follow-up.