Clinical Outcomes following Primary Hip Replacement Arthroplasties in Patients with Solid Organ Transplantation: A Systematic Review and Meta-Analysis

Abstract

There is still controversy regarding clinical outcomes following primary hip arthroplasty after solid organ transplantation (SOT). The aim of this study was to determine whether clinical outcomes after hip arthroplasty differ between previous SOT recipients and control subjects with no history of undergoing SOT. We conducted a systematic search of MEDLINE, Embase, and the Cochrane Library for studies comparing the clinical outcomes after hip arthroplasty following SOT published up to January 5, 2022. A comparison of medical and surgery-related complications, as well as the readmission rate and 90-day mortality rate between previous SOT recipients and control subjects was performed. Subgroup analyses of the SOT types, liver transplantation (LT) and kidney transplantation (KT), were also performed. Ten studies that included 3,631,861 cases of primary hip arthroplasty were included; among these, 14,996 patients had previously undergone SOT and 3,616,865 patients had not. Significantly higher incidences of cardiac complications, pneumonia, and acute kidney injury were observed in the SOT group compared with the control group. Regarding surgical complications, a higher transfusion rate was observed in the SOT group. The readmission rate and 90-day mortality rate were also significantly higher in the SOT group. A significantly higher incidence of deep vein thrombosis was observed in the KT subgroup compared with the control group. A higher risk of medical and surgical complications, as well as higher readmission and mortality rates after hip arthroplasty was observed for previous SOT recipients compared to patients with no history of SOT.

Outcomes of total hip and knee arthroplasty in special populations: a synopsis and critical appraisal of systematic reviews

“…A total of 17 SRs were included [ 1 , 2 , 6 , 7 , 14 – 26 ] (Table 1 ); these investigated THA and/or TKA outcomes and complications in the following patient-related characteristics: a) Smoking (9 SRs), alcohol excess (4 SRs), RA (3 SRs), Hepatitis C (2 SRs), HIV (two SRs), depression (1 SR), solid organ transplants (1 SR). Four SRs assessed more than one characteristic [ 2 , 6 , 7 , 14 ].…”

“…Finally, in the included SR, although primary THA in those with solid organ transplants was associated with similar incidences of surgical complications compared to controls, there was a significantly greater incidence of cardiac complications, pneumonia and acute kidney injury [ 26 ]. Transfusion rates and 90-day re-admission rates were also found to be higher in those with solid organ transplants.…”