Revision Total Hip and Knee Arthroplasties After Solid Organ Transplant

Ledford, Cameron K.; Statz, Joseph M.; Chalmers, Brian P.; Perry, Kevin I.; Hanssen, Arlen D.; Abdel, Matthew P.

doi:10.1016/j.arth.2016.11.047

Cited by 19 publications

(17 citation statements)

References 30 publications

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“…In addition to increased readmissions, more reoperations (10%) and surgical complications (16%) were found in the SOT undergoing hip arthroplasty for FNF, although they were not significantly different than the matched cohort with the numbers available. Numerous prior reports have demonstrated the increased risk of reoperations and complications after elective hip and knee arthroplasty in SOT patients [20][21][22][23][24][25]. Ledford et al cited periprosthetic joint infection as the most common indication for revision in a series of revision THAs performed in SOT [22].…”

Section: Discussionmentioning

confidence: 99%

“…Numerous prior reports have demonstrated the increased risk of reoperations and complications after elective hip and knee arthroplasty in SOT patients [20][21][22][23][24][25]. Ledford et al cited periprosthetic joint infection as the most common indication for revision in a series of revision THAs performed in SOT [22]. In contrast, a large database review by Labaran et al unexpectedly showed mechanical loosening, not infections, to be the leading indication for renal transplant patients undergoing revision THA [37].…”

Section: Discussionmentioning

confidence: 99%

“…The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article. literature has demonstrated increased complications, infection, and mortality after total hip arthroplasty (THA) performed in SOT recipients [19][20][21][22][23][24][25]. However, the vast majority of surgical indications for THA in these studies are elective (degenerative joint disease or avascular necrosis), not urgent hip fracture surgery.…”

Section: Declaration Of Interestsmentioning

confidence: 99%

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Outcomes of Femoral Neck Fracture Treated With Hip Arthroplasty in Solid Organ Transplant Patients

et al. 2021

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Background: Solid organ transplant (SOT) patients have increased risk of complications, infection, and mortality after elective total hip arthroplasty (THA). The study aims to compare SOT recipients' clinical outcomes to a matched group of nontransplant patients after nonelective THA and hemiarthroplasty for acute femoral neck fracture (FNF). Methods: A retrospective review identified 31 SOT patients undergoing hip arthroplasty (24 hemiarthroplasty and 7 THA) for FNF and were matched 1:1 to non-SOT patients based on age, sex, body mass index, surgical procedure, and year of surgery. Patient survivorship, perioperative outcomes, complications, and reoperations were compared. The mean follow-up was 3 years. Results: The estimated survivorship free from mortality for SOT and non-SOT patients at 1-year was not different (77% and 84%, respectively, P ¼ .52). The 90-day readmission rate was significantly higher with 8 (26%) in the SOT cohort and none in the non-SOT group (P < .01). Major medical complications occurred in 16% of SOT patients compared to 5% in controls (P ¼ .21). Three (10%) reoperations/revisions were required for SOT patients and none in non-SOT group (P ¼ .24). Conclusion: SOT recipients undergoing nonelective hip arthroplasty for FNF demonstrated increased readmission rates compared to matched controls. For this rare clinical scenario, diligent perioperative care by surgeons and multidisciplinary transplant specialists is necessary to mitigate increased risk of SOT patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Declaration Of Interestsmentioning

confidence: 99%

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Outcomes of Femoral Neck Fracture Treated With Hip Arthroplasty in Solid Organ Transplant Patients

et al. 2021

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“…In a single institution case series of 9 rTKA patients, Ledford et al. described outcomes in 30 SOT patients undergoing rTHA, of which 3 underwent re-revision for PJI and 3 for instability (total of 6, or 20%) at a mean of 2.1 years [ 9 ]. This is roughly comparable to the 90-day rate of re-operation following rTHA for PJI (12.3%) in SOT patients in this study.…”

Section: Discussionmentioning

confidence: 99%

“…It is less clear how SOT patients do after revision THA (rTHA). A retrospective case series of 30 patients found an elevated risk for re-revision, particularly for prosthetic joint infection (PJI) in patients with a history of SOT [ 9 ]. More recently, Labaran et al.…”

Section: Introductionmentioning

confidence: 99%

Revision Total Hip Arthroplasty in Solid Organ Transplant Patients: A Propensity Score-Matched Cohort Study for Aseptic and Infected Revisions

et al. 2022

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Background Previous studies have demonstrated that solid organ transplant (SOT) patients undergoing primary total hip arthroplasty (THA) are at an increased risk of postoperative complications. The purpose of this study is to use a large, national database to investigate revision THA (rTHA) outcomes in SOT patients. Methods Nationwide Readmissions Database (NRD) from 2010-2018 was used, and ICD-9 and ICD-10 codes were used to identify all patients who underwent rTHA, including those with history of SOT. Propensity score matching (PSM) was used to analyze rTHA outcomes in SOT patients comparted to matched controls. Separate analysis performed for patients undergoing rTHA for prosthetic joint infection (PJI) vs other causes. Results A total of 414,756 rTHA, with 1837 of those being performed in SOT patients, were identified. Of these, 65,961 and 276 were performed for PJI in non-SOT and SOT patients, respectively. For non-PJI patients, SOT patients had higher 90-day all-cause readmission rates (24.0% vs 19.4%, P = .03) but lower rate for readmission related to rTHA (6.0% vs 9.2%, P = .03), but no difference readmission for specific rTHA complications, mortality (0.6% vs 1.3%, P = .20), or revision rTHA. Of PJI patients, SOT patients had no difference in overall 90-day readmission (38.6 vs 31.3%, P = .280), readmission for specific rTHA complications, re-revision, or mortality (4.7% vs 6.0%, P = .63). Conclusions SOT patients undergoing rTHA for aseptic reasons are higher risk of overall readmission but lower risk of readmission related to rTHA than appropriately matched controls. SOT PJI patients undergoing had similar rates of readmission, mortality, and revision surgery compared to matched non-SOT PJI patients.

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Intertrochanteric fracture fixation in solid organ transplant patients: outcomes and survivorship

VanWagner

Porter

Spaulding

et al. 2021

Arch Orthop Trauma Surg

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Revision Total Hip and Knee Arthroplasties After Solid Organ Transplant

Cited by 19 publications

References 30 publications

Outcomes of Femoral Neck Fracture Treated With Hip Arthroplasty in Solid Organ Transplant Patients

Outcomes of Femoral Neck Fracture Treated With Hip Arthroplasty in Solid Organ Transplant Patients

Revision Total Hip Arthroplasty in Solid Organ Transplant Patients: A Propensity Score-Matched Cohort Study for Aseptic and Infected Revisions

Intertrochanteric fracture fixation in solid organ transplant patients: outcomes and survivorship

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