Hereditary hemochromatosis as a risk factor for joint replacement surgery.
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.
Sahinbegovic
Enijad
E
Department of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany.
Dallos
Tomás
T
Aigner
Elmar
E
Axmann
Roland
R
Engelbrecht
Matthias
M
Schöniger-Hekele
Maximilian
M
Karonitsch
Thomas
T
Farkas
Martin
M
Karger
Thomas
T
Willeit
Johann
J
Stölzel
Ulrich
U
Keysser
Gernot
G
Datz
Christian
C
Kiechl
Stefan
S
Schett
Georg
G
Zwerina
Jochen
J
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