TOTAL  KNEE  AND CANCER


     

    Alloys used for manufacture of  total hip prostheses contain materials which are potentially carcinogenic in animals.

    It is also known   that levels of some metals (Chromium, Nickel, e.g) are elevated both in the   tissues around the total hip joint and in the blood of  patients with total hips.

    Also bone cement contains materials with potential carcinogenic effect that may enter into the   circulation.

    As more and more young patients are operated on with total hips, the effect of these materials on the bodies of young patients will last 30 and more years. The question whether total joints may give rise to cancer in the bodies of their bearers is thus studied   intensively.


    Questions:

    Is there risk that I may develop cancer in the skeleton and soft tissues around my total joint?

    No. Studies demonstrated that cancer in the vicinity of a total hip or knee joint is extremely rare. During the whole modern history of total joint replacement only 24 such cases were described among the many millions of patients operated on worldwide. (Tharani 2001)

    Are other forms of cancer, such as stomach, bowel, and other forms more frequent in patients operated on with total hip and total knee joints?

       No. Studies demonstrated that patients with total hip and knee prostheses implanted in their bodies are not at greater risk to develop cancer than the people in the general population.

    Do patients with more than one total joint prosthesis in the body, such as patients with bilateral total hip or bilateral total knee replacements develop more often cancer than people in the general population?

    No. The available studies demonstrate that the risk to have cancer is not greater in patients who have both hips or both knees replaced.

    Do patients who have had repeated operations (revision operations) of their total hip or knee prostheses have cancer more often than the general population?

    No. Available studies demonstrate that cancer risk is not higher in patients with repeatedly operated total hip or knee prostheses. (Tharani 2001)

    Is the risk for having  cancer after total knee replacement different for patients with different diagnoses?

    Yes, studies demonstrated that patients with rheumatoid arthritis have higher risk to develop cancer after total knee replacement than patients operated for osteoarthritis in their knees.

    Is the risk of having cancer after total knee replacement higher for patients who have had the total knee prosthesis in the body several years?

    This question is difficult to answer. One study that followed  patients with total knee replacement for ten years did not find higher incidence of cancer among them. Studies with longer follow up > 10 years  are as yet lacking for patients with  total knee replacements. (Pavolainen 1999)


     

References

Paavolainen P.  Acta Orthop Scand 1999;70: 609-17

Tharani R et al.  J Bone Joint Surg-Am; 2001; 83-A:774- 80


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