Dialysis patients have comparable results to patients who have received kidney transplant after total joint arthroplasty: a systematic review and meta-analysis

Abstract

Patients with end-stage renal disease (ESRD) have inferior outcomes after hip and knee total joint arthroplasty (TJA), with higher risk for surgical site complications (SSC) and periprosthetic joint infection (PJI). We conducted a systematic review and meta-analysis regarding outcomes after hip and knee TJA in ESRD patients who have received dialysis or a kidney transplant (KT) using PubMed, MEDLINE, Cochrane Reviews, and Embase in order to: (1) determine the mortality and infection rate of TJA in patients receiving dialysis or KT and (2) to identify risk factors associated with the outcome. We included 22 studies and 9384 patients (dialysis, n = 8921, KT, n = 463). The overall mortality rate was 14.9% and was slightly higher in KT patients (dialysis vs. KT, 13.8% vs. 15.8%). The overall SSC rate was 3.4%, while dialysis and KT patients each had an incidence of 3.3% and 3.6%, respectively. For PJI, the overall rate was 3.9%, while the incidence for dialysis patients was 4.0% and for KT patients was 3.7%. Using multi-regression analysis, age, sex, the type of arthroplasty (knee or hip) performed, and the form of renal replacement therapy (dialysis or KT) were not significant risk factors. In patients on dialysis or who had received a KT, TJA is associated with a slight increase in mortality, SSC and PJI rates. Cite this article: EFORT Open Rev 2021;6:618-628. DOI: 10.1302/2058-5241.6.200116

Effect of endoscopic loop ties in acute appendicitis on wound infection rate: A meta‐analysis

“…Bigger, more homogeneous samples are mandatory for this examination. This was also emphasised in preceding studies that used a linked meta‐analysis technique and found equivalent values of the influence 51‐55 . Although the meta‐analysis was incapable to discover if differences in these characteristics are related to the outcomes being researched, properly‐led RCTs are vital to consider these aspects as well as the mixture of different ages, genders, and ethnicities of subjects.…”

“…This was also emphasised in preceding studies that used a linked meta-analysis technique and found equivalent values of the influence. [51][52][53][54][55] Although the meta-analysis was incapable to discover if differences in these characteristics are related to the outcomes being researched, properly-led RCTs are vital to consider these aspects as well as the mixture of different ages, genders, and ethnicities of subjects. In conclusion, open surgery had a significantly higher postoperative SSWI compared to ELT in AA subjects.…”

Knee and hip arthroplasty joint surgical site wound infection in end‐stage renal disease subjects who underwent dialysis or a kidney transplant: A meta‐analysis

“…Bigger, more homogeneous samples are mandatory for this examination. This was also emphasised in preceding studies that used a linked meta‐analysis technique and found equivalent consequences of the influence 6,43,44 . Well‐led RCTs are necessary to weigh these features as well as the blend of diverse ethnicities, ages, gender, and other parameters of subjects because the meta‐analysis could not define whether differences in them are linked to the outcomes studied.…”

End-stage renal disease patients have comparable results to renal transplant patients after shoulder arthroplasty

“…With medical advances and increased success of maintenance treatment for ESRD and RT, there will continue to be a rise in the number of these patients undergoing SA. 7 , 12 THA and TKA have been studied extensively, comparing results between both the RT and ESRD patient population. 9 , 17 25 , 26 28 , 31 , 34 , 35 , 36 Li et al’s meta-analysis of 10 studies and 6904 patients showed that RT patients had a lower risk of mortality, revision surgeries, and PJIs compared to ESRD patients when undergoing THA or TKA.…”

“… 9 , 17 25 , 26 28 , 31 , 34 , 35 , 36 Li et al’s meta-analysis of 10 studies and 6904 patients showed that RT patients had a lower risk of mortality, revision surgeries, and PJIs compared to ESRD patients when undergoing THA or TKA. 26 Chou et al’s 7 meta-analysis which included 22 studies and 9384 patients undergoing THA or TKA showed a slightly increased mortality rate, surgical site complication, and PJI, however all without a significant trend, when comparing ESRD patients to RT patients. Lieu et al’s 27 study looked at THA in 128 ESRD and 406 RT patients and showed that ESRD patients had twice the infection rates, higher rates of mortality, AL, and hip dislocations.…”