Primary arthroplasty of the hip and knee are amongst the most common elective surgical procedures carried out. Results are uniformly good with low complication rates. However, there is a subset of patients in whom a general malaise has been noted. Many of these patients have been seen to have elevated liver function tests.

This study set out to examine the effects of primary arthroplasty on liver function and to establish differences between subsets of patients in a consecutive single surgeon series between June 2003 and September 2007 inclusive.

In total, 374 procedures were carried out on 350 patients. There were 186 male and 164 female patients. The mean age of the patients was 64.97+/−10.02 years with no significant difference between sexes. Hip replacement accounted for 196 cases (69 cemented, 68 hybrid and 59 cementless) and there was 178 knee replacements. All 4 measurements (AST, ALT, Alk phos, Gamma GT) were significantly elevated at 1 week post-op compared to pre-op and 1 day post-op. All except Alk phos returned to normal at 6 weeks post-op. There were no differences recorded between males and females, hips and knees and the subsets of hips.

It is clear from these results that liver function is affected by primary arthroplasty with no single subset providing a reason. Additional research is required to further evaluate these changes.