Increased prevalence of gastric pathologies in patients with total hip and total knee prostheses: a retrospective endoscopic study

Year 2023, Volume: 5 Issue: 3, 242 - 246, 28.07.2023

Ali Muhtaroğlu , Ahmet Dülger

https://doi.org/10.38053/acmj.1290478

Abstract

Aims: The objective of this retrospective study was to evaluate the prevalence of Helicobacter pylori (H. pylori) positivity, gastric atrophy, and intestinal metaplasia in patients with dyspeptic complaints who had undergone total hip and knee replacement surgeries, compared to a control group without prosthesis.
Methods: The study group consisted of 51 patients with dyspeptic complaints and total knee and hip prosthesis, while the control group comprised 75 patients with similar complaints but without prosthesis. Endoscopic gastric biopsies were obtained from all participants, and the presence of H. pylori, gastric atrophy, and intestinal metaplasia were evaluated.
Results: The prevalence of H. pylori positivity, gastric atrophy, and intestinal metaplasia were significantly higher in patients who underwent total knee and hip replacement compared to the control group without prosthesis.
Conclusion: The results of this study suggest that patients who undergo total hip and knee replacement surgeries may be at higher risk for developing gastric pathologies, such as H. pylori infection, gastric atrophy, and intestinal metaplasia. Therefore, it is recommended that physicians who care for these patients monitor them closely for these conditions and consider endoscopic surveillance as part of their management plan.

Keywords

Total knee arthroplasty, total hip arthroplasty, H. pylori, atrophy, intestinal metaplasia

Project Number

-

References

• Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to. 2030. J Bone Joint Surg Am. 2007;89:780–785.
• Passias P, Bono JV. Total hip arthroplasty in the older population. Geriatr Aging. 2006;9:535-543.
• Bang H, Chiu YL, Memtsoudis SG, et al. Total hip and total knee arthroplasties:trends and disparities revisited. Am J Orthop. 2010;39:E95-102.
• Fang M, Noiseux N, Linson E, Cram P. The effect of advancing age on total joint replacement outcomes. Geriatr Orthop Surg Rehabil. 2015;6:173-179.
• Neuprez A, Neuprez AH, Kaux JF, et al. Total joint replacement improves pain, functional quality of life, and health utilities in patients with late-stage knee and hip osteoarthritis for up to 5 years. Clin Rheumatol. 2019;39:861–871.
• Hooi JKY, Lai WY, Ng WK, et al. Global prevalence of Helicobacter pylori infection: systematic review and meta-analysis. Gastroenterology. 2017;153:420-429.
• Lee CW, Rickman B, Rogers AB, Ge Z, Wang TC, Fox JG. Helicobacter pylori eradication prevents progression of gastric cancer in hypergastrinemic INS-GAS mice. Cancer Res. 2008;68:3540-3548.
• Harirforoosh S, Asghar W, Jamali F. Adverse effects of nonsteroidal antiinflammatory drugs:an update of gastrointestinal, cardiovascular and renal complications. J Pharm Pharm Sci. 2013;16:821-847.
• Karsenty G, Ferron, M. The contribution of bone to whole-organism physiology. Nat Cell Biol. 2012;481:314–320.
• Ramsey W, Isales CM. Intestinal Incretins and the Regulation of Bone Physiology. Adv Exp Med Biol. 2017;1033:13-33.
• Schiellerup SP, Skov-Jeppesen K, Windeløv JA, et al. Gut hormones and their effect on bone metabolism. potential drug therapies in future osteoporosis treatment. Front Endocrinol (Lausanne). 2019;10:75.
• Savoldi A, Carrara E, Graham DY, Conti M, Tacconelli E. Prevalence of antibiotic resistance in helicobacter pylori:a systematic review and meta-analysis in World Health Organization Regions. Gastroenterology. 2018;155:1372-1382.
• Haruma K, Kamada T, Kawaguchi H, et al. Effect of age and Helicobacter pylori infection on gastric acid secretion. J Gastroenterol Hepatol. 2000;15:277–283.
• Erdoğdu UE, Demirci H, Çaycı HM, Erkinüresin T. Facts for life and Helicobacter pylori infection. Haydarpasa Numune Med J. 2020;60:5–9.
• Wainwright C, Theis JC, Garneti N, Melloh M. Age at hip or knee joint replacement surgery predicts likelihood of revision surgery. J Bone Joint Surg Br. 2011;93:1411-1415.
• Massaglia J, Yayac M, Star A, Deirmengian G, Courtney PM, Saxena A. Gastrointestinal complications following total joint arthroplasty are rare but have severe consequences. J Arthroplasty. 2021;36:2974-1979.
• Adenikinju AS, Feng JE, Namba CA, Luthringer TA, Lajam CM. Gastrointestinal complications warranting invasive interventions following total joint arthroplasty. J Arthroplasty. 2019;34:2780-2784.
• Bekeris J, Fiasconaro M, Della Valle AG, et al. Modifiable analgesia-/anesthesia-related factors and risk of severe gastrointestinal complications after lower extremity total joint arthroplasty:a nationwide analysis. J Arthroplasty. 2020;35:2624-2630.
• Heo SM, Harris I, Naylor J, Lewin AM. Complications to 6 months following total hip or knee arthroplasty: observations from an Australian clinical outcomes registry. BMC Musculoskelet Disord. 2020;21:602.
• Hnepa YY, Chopey IV, Chubirko KI, Bratasyuk AM. Short- and long-term effects of NSAIDs on the gastrointestinal mucosa:complex analysis of benefits and complications prevention. Wiad Lek. 2021;74:1011-1018.
• Lalmohamed A, Vestergaard P, Klop C, et al. Timing of acute myocardial infarction in patients undergoing total hip or knee replacement:a nationwide cohort study. Arch Intern Med. 2012;172:1229-1235.
• McCarthy DM. Helicobacter pylori and non-steroidal anti-inflammatory drugs:does infection affect the outcome of NSAID therapy? Yale J Biol Med 1998;71:101-111.
• Dreyer HC, Owen EC, Strycker LA, et al. Essential amino acid supplementation mitigates muscle atrophy after total knee arthroplasty:a randomized, double-blind, placebo-controlled trial. JB JS Open Access. 2018;3:e0006.
• Tang SJ, Wu R, Bhaijee F. Intestinal metaplasia of the stomach. VJGIEN. 2013;1:187-189.