title: Hereditary hemochromatosis as a risk factor for joint replacement surgery.
abstract: OBJECTIVE
  Hemochromatosis is an inherited disease with iron overload and joint involvement resembling osteoarthritis. To determine the rate of joint replacement surgery in patients with hemochromatosis, we performed a cross-sectional cohort study.
  
  
  METHODS
  A total of 199 individuals with hereditary hemochromatosis were included. The prevalence of joint replacement surgery in hip, knee, and ankle joints because of secondary osteoarthritis was assessed. Data were compared with 917 healthy subjects from the population-based Bruneck study.
  
  
  RESULTS
  A total of 32 of 199 individuals with hemochromatosis received joint replacement surgery with a total number of 52 joints replaced. Compared with expected rates in healthy individuals, patients with hemochromatosis had a significantly higher risk for joint replacement surgery (odds ratio 9.0; confidence interval, 4.6-17.4). Joint replacement occurred significantly earlier in life in patients with hemochromatosis; 21.9% of the patients with hemochromatosis and 1.7% of healthy individuals required joint replacement before the age of 50 years (P=.0027). Moreover, patients with hemochromatosis were more likely to require multiple joint replacements (8.5%) than the control group (expected rate 0.3%; P=.0001).
  
  
  CONCLUSIONS
  Hemochromatosis is a risk factor for joint replacement surgery because of severe secondary osteoarthritis.
authors.affiliation: Department of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Enijad
authors.initials: E
authors.lastname: Sahinbegovic
authors.forename: Tomás
authors.initials: T
authors.lastname: Dallos
authors.forename: Elmar
authors.initials: E
authors.lastname: Aigner
authors.forename: Roland
authors.initials: R
authors.lastname: Axmann
authors.forename: Matthias
authors.initials: M
authors.lastname: Engelbrecht
authors.forename: Maximilian
authors.initials: M
authors.lastname: Schöniger-Hekele
authors.forename: Thomas
authors.initials: T
authors.lastname: Karonitsch
authors.forename: Martin
authors.initials: M
authors.lastname: Farkas
authors.forename: Thomas
authors.initials: T
authors.lastname: Karger
authors.forename: Johann
authors.initials: J
authors.lastname: Willeit
authors.forename: Ulrich
authors.initials: U
authors.lastname: Stölzel
authors.forename: Gernot
authors.initials: G
authors.lastname: Keysser
authors.forename: Christian
authors.initials: C
authors.lastname: Datz
authors.forename: Stefan
authors.initials: S
authors.lastname: Kiechl
authors.forename: Georg
authors.initials: G
authors.lastname: Schett
authors.forename: Jochen
authors.initials: J
authors.lastname: Zwerina
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D019643:Arthroplasty, Replacement / Q000706:statistics & numerical data*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006432:Hemochromatosis / Q000150:complications* / Q000235:genetics*; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000209:etiology* / Q000601:surgery*; D012307:Risk Factors