Upper gastrointestinal bleeding after hip and knee arthroplasty

The use of nonsteroidal anti-inflammatory drugs (NSAIDs) and anticoagulants increases the risk of upper gastrointestinal bleeding. This article assesses its incidence in patients undergoing hip and knee arthroplasty. A single-center, retrospective study was conducted on 100 consecutive hip and 100 consecutive knee arthroplasties performed at the Victoria Infirmary, Glasgow, between 1998 and 2000. Sixty-three percent of patients were women with a mean age of 74. Fifty-four percent of patients received NSAIDs and all patients received anticoagulants perioperatively. Four and a half percent of patients had upper gastrointestinal bleeding postoperatively. We believe that the incidence of upper gastrointestinal bleeding as a complication is underestimated and recommend gastro-protective agents in the perioperative period for patients on NSAIDs.