ArticleJAMA network open2022
Long-term Cognitive Trajectory After Total Joint Arthroplasty.
Article in JAMA network open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Metal-on-metal arthroplasty, cobalt toxicity, and development of cognitive impairment: a systematic review.Archives of orthopaedic and trauma surgery · 2025Pooled it
- Cobalt and titanium levels in the brain are associated with Alzheimer's disease pathology but not cognition: A study of older adults with and without total joint replacement.Acta biomaterialia · 2026Article
- Long-Term Risk of Dementia up to Three Decades After Total Joint Arthroplasty: A Population-Based Cohort Study.The Journal of arthroplasty · 2026Article
- Perioperative Outcomes of Cemented vs Cementless Total Hip Arthroplasty: A National Inpatient Sample Study of 81,668 Elective Procedures.Journal of clinical medicine · 2026Article
- Osteoarthritis as a systemic disease.Nature reviews. Rheumatology · 2026Review
- Brain tissue metal concentrations and Alzheimer's disease neuropathology in total joint arthroplasty patients versus controls.Acta neuropathologica · 2025Article
- Genetically predicted effects of 10 sleep phenotypes on revision of knee arthroplasty: a mendelian randomization study.Journal of orthopaedic surgery and research · 2024Article
- Interplay between orthopedic interventions and dementia: Dementia risk after total knee replacement.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Article
- Postoperative cognitive dysfunction: a concept analysis.Aging clinical and experimental research · 2024Review
- Association between surgery and rate of incident dementia in older adults: A population-based retrospective cohort study.Journal of the American Geriatrics Society · 2024Article
- Long-term cognitive outcome after elective hip or knee total joint arthroplasty: A population-based observational study.Journal of the American Geriatrics Society · 2024Observational
- Mayo-PACC: A parsimonious preclinical Alzheimer's disease cognitive composite comprised of public-domain measures to facilitate clinical translation.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2023Article
- Correlation of Blood Metal Concentrations with Cognitive Scores and Neuroimaging Findings in Patients with Total Joint Arthroplasty.Journal of Alzheimer's disease : JAD · 2023Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
Importance: Individuals with total joint arthroplasty (TJA) have long-term exposure to metal-containing implants; however, whether long-term exposure to artificial implants is associated with cognitive function is unknown. Objective: To compare long-term cognitive trajectories in individuals with and without TJA. Design, Setting, and Participants: This population-based cohort study assessed serial cognitive evaluations of 5550 participants (≥50 years of age) from the Mayo Clinic Study of Aging between November 1, 2004, and December 31, 2020. Exposures: Total joint arthroplasty of the hip or the knee. Main Outcomes and Measures: Linear mixed-effects models were used to compare the annualized rate of change in global and domain-specific cognitive scores in participants with and without TJA, adjusting for age, sex, educational level, apolipoprotein E ε4 carrier status, and cognitive test practice effects. Results: A total of 5550 participants (mean [SD] age at baseline, 73.04 [10.02] years; 2830 [51.0%] male) were evaluated. A total of 952 participants had undergone at least 1 TJA of the hip (THA, n = 430) or the knee (TKA, n = 626) before or after entry into the cohort. Participants with TJA were older, more likely to be female, and had a higher body mass index than participants without TJA. No difference was observed in the rate of cognitive decline in participants with and without TJA until 80 years of age. A slightly faster cognitive decline at 80 years or older and more than 8 years from surgery was observed (b = -0.03; 95% CI, -0.04 to -0.02). In stratified analyses by surgery type, the faster decline was observed primarily among older participants with TKA (b = -0.04; 95% CI, -0.06 to -0.02). Conclusions and Relevance: In this cohort study, long-term cognitive trajectories in individuals with and without TJA were largely similar except for a slightly faster decline among the oldest patients with TKA; however, the magnitude of difference was small and of unknown clinical significance.
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