Early Postoperative Outcomes of Primary Total Knee Arthroplasty After Solid Organ Transplantation in the United States, 1998–2011

Klika, Alison K.; Myers, Thomas G.; Szubski, Caleb R.; Schiltz, Nicholas K.; Navale, Suparna M.; Barsoum, Wael K.

doi:10.1016/j.arth.2015.04.044

Cited by 28 publications

(19 citation statements)

References 16 publications

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“…Reports suggest that the hospitalization period for this patient group is longer than the patients without a transplanted organ [16]. In our study, the mean postoperative length of stay was 8.5 (5.6) days, and four patients were discharged within a similar number of days compared to the patients without a previous history of transplant surgery.…”

Section: Discussionsupporting

confidence: 45%

Evaluation of spinal instrumentation following organ transplantation: A retrospective cohort study

Mert¹,

Ermutlu²

2020

Journal of Surgery and Medicine

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Aim: Improvements in transplantation medicine and surgery, anesthesiology, and postoperative care paved the way for successful procedures for transplant patients. The aim of the present study is to describe the results of surgical correction for spinal deformities in patients who underwent several types of organ transplantation. Methods: The study group consisted of ten patients with a history of organ transplantation who require spinal surgery with different etiologies. Seven (70%), two (20%) and one (10%) patient had lung, liver, and lung transplantations, respectively. The etiology for spinal surgery was spinal stenosis in six (60%), vertebra fracture in three (30%), and vertebral metastasis in one (10%) patient. Preintra-and postoperative radiological, clinical, and functional outcomes were noted. Results: The mean age of the patients was 57.1 (8.9) years, ranging between 38-62 years. Six of the patients were male, and four were female. Surgery time following the transplant surgery was 15.6 (2.1) months. The blood requirement in the operating room was 5.6 (0.8) units of erythrocyte suspension. Hospital length of stay was 8.5 (5.6) days following the spinal instrumentation surgery. Two patients had mild complications in the postoperative period. The preoperative VAS score significantly decreased from 6.4 (0.8) to 3.1 (1.6) after the surgery (P<0.001). Conclusions: Posterior spinal instrumentation on transplanted patients can be an effective treatment which improves the life quality of the patients. A multidisciplinary approach with an experienced team is highly required.

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Section: Discussionsupporting

confidence: 45%

Evaluation of spinal instrumentation following organ transplantation: A retrospective cohort study

Mert¹,

Ermutlu²

2020

Journal of Surgery and Medicine

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“… 34 , 41 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 The strongest evidence supported increased LOS associated with perioperative risk factors. 21 , 34 , 41 , 43 , 44 , 45 , 46 , 48 , 51 , 53 , 54 , 55 , 56 , 57 , 58 …”

Section: Resultsmentioning

confidence: 99%

Risk Factors Associated With Health Care Utilization and Costs of Patients Undergoing Lower Extremity Joint Replacement

Knoedler

Jeffery

Philpot

et al. 2018

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

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BackgroundThe Comprehensive Care for Joint Replacement program implemented by the Centers for Medicare and Medicaid Services did not incorporate risk adjustment for lower extremity joint replacement (LEJR). Lack of adjustment places hospitals at financial risk and creates incentives for adverse patient selection.ObjectiveTo identify patient-level risk factors associated with health care utilization and costs of patients undergoing LEJR.MethodsA comprehensive search of research databases from January 1, 1990, through January 31, 2016, was conducted. The databases included Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and SCOPUS and is reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. The search identified 2020 studies. Eligible studies focused on primary unilateral and bilateral LEJR. Independent reviewers determined study eligibility and extracted utilization and cost data.ResultsSeventy-nine of 330 studies (24%) were included and were abstracted for analysis. Comorbidities, age, disease severity, and obesity were associated with increased costs. Increased number of comorbidities and age, presence of specific comorbidities, lower socioeconomic status, and female sex had evidence of increased length of stay. We found no significant association between indication for surgery and the likelihood of readmission.ConclusionDeveloping a risk adjustment model for LEJR that incorporates clinical variables may serve to reduce the likelihood of adverse patient selection and enhance appropriate reimbursement aligned with procedural complexity.

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“…However, across surgical specialties, in comparative studies of elective surgical procedures adjusting for underlying medical comorbidity, SOT patients have similar rates of post-operative infections and wound complications [22,23]. Prior studies on complications following TJA in SOT patients have also not conclusively shown an increased risk [5,[24][25][26][27]. The reasons for this may be threefold.…”

Section: Discussionmentioning

confidence: 99%

“…At the same time, survivorship in patients who have undergone solid organ transplant (SOT) has steadily improved in part because of improvements in surgical technique and postoperative immunosuppression and surveillance protocols [ 3 ]. As SOT patients live longer, the incidence of symptomatic arthritis is likely to increase, leading to an increased demand for both primary and revision joint replacement procedures [ 4 , 5 ]. SOT patients are also at higher risk to develop femoral head avascular necrosis, patients with renal transplants, in particular, undergo THA at 5-8 times the rate of the general population [ 6 ].…”

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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Early Postoperative Outcomes of Primary Total Knee Arthroplasty After Solid Organ Transplantation in the United States, 1998–2011

Cited by 28 publications

References 16 publications

Evaluation of spinal instrumentation following organ transplantation: A retrospective cohort study

Evaluation of spinal instrumentation following organ transplantation: A retrospective cohort study

Risk Factors Associated With Health Care Utilization and Costs of Patients Undergoing Lower Extremity Joint Replacement

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

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