OBJECTIVE: Hemochromatosis is an inherited disease with iron overload and joint 
involvement resembling osteoarthritis. To determine the rate of joint 
replacement surgery in patients with hemochromatosis, we performed a 
cross-sectional cohort study.
METHODS: A total of 199 individuals with hereditary hemochromatosis were 
included. The prevalence of joint replacement surgery in hip, knee, and ankle 
joints because of secondary osteoarthritis was assessed. Data were compared with 
917 healthy subjects from the population-based Bruneck study.
RESULTS: A total of 32 of 199 individuals with hemochromatosis received joint 
replacement surgery with a total number of 52 joints replaced. Compared with 
expected rates in healthy individuals, patients with hemochromatosis had a 
significantly higher risk for joint replacement surgery (odds ratio 9.0; 
confidence interval, 4.6-17.4). Joint replacement occurred significantly earlier 
in life in patients with hemochromatosis; 21.9% of the patients with 
hemochromatosis and 1.7% of healthy individuals required joint replacement 
before the age of 50 years (P=.0027). Moreover, patients with hemochromatosis 
were more likely to require multiple joint replacements (8.5%) than the control 
group (expected rate 0.3%; P=.0001).
CONCLUSION: Hemochromatosis is a risk factor for joint replacement surgery 
because of severe secondary osteoarthritis.