Outcome analysis of hip or knee arthroplasty in patients with cirrhotic liver disease

Seol, Young-Jun; Yoon, Tae Mi; Lee, Dong-Hyun; Lee, Sun-Ho; Park, Kyung-Soon

doi:10.1016/j.jor.2016.12.011

Cited by 14 publications

(15 citation statements)

References 23 publications

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“…A total of 26 relevant article titles were identified. After application of eligibility criteria described, eight studies [11–18] qualified for inclusion. Two further studies [19, 20] reported on outcomes of THA in patients post liver transplantation for CLD, and this was deemed an interesting group for comment separately.…”

Section: Resultsmentioning

confidence: 99%

“…Six studies reported on implant failure and revision rates [11–13, 16–18]. There was an increased rate of revision surgery at 4% (46/1083 THAs) compared with 0.2% in controls ( p < 0.001).…”

Section: Resultsmentioning

confidence: 99%

“…Infection rate was reported in seven studies [12–18], which included 28 495 THAs. There was an increased infection rate in CLD patients, at 0.5% (range 0.3%–15.4%) compared with 0.15% in controls ( p < 0.001).…”

Section: Resultsmentioning

confidence: 99%

“…There was an increased infection rate in CLD patients, at 0.5% (range 0.3%–15.4%) compared with 0.15% in controls ( p < 0.001). Two studies recorded separate infection rates for elective arthroplasty cases versus emergency cases [13, 18]. This amounted to 954 THAs, including 803 elective cases and 151 urgent procedures.…”

Section: Resultsmentioning

confidence: 99%

“…Perioperative mortality rates were documented in five studies [11–14, 18] amounting to 1048 THAs. The mean perioperative mortality rate was increased in CLD patients at 4.1% compared with 0.2% in controls ( p < 0.001).…”

Section: Resultsmentioning

confidence: 99%

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Total hip arthroplasty in patients with chronic liver disease: A systematic review

Onochie

Kayani

Dawson-Bowling

et al. 2019

SICOT-J

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Introduction: Chronic liver disease (CLD) is a significant and increasingly prevalent co-morbidity in patients undergoing total hip arthroplasty (THA). These patients may develop metabolic bone disease (MBD) and systemic dysfunction, which pose challenges to THA surgery. This systematic review of literature aims to examine clinical outcomes and complications in patients with CLD undergoing THA and provide evidence-based approaches as to the optimization of their perioperative care.Methods: A Pubmed search was performed, identifying eight studies on 28 514 THAs for inclusion. Two additional studies reported on 44 patients undergoing THA post liver transplant. These were reviewed separately.Results: Increased early perioperative complications are reported recurrently. Review of long-term complications demonstrates an increased postoperative infection rate of 0.5% (p < 0.001) and perioperative mortality of 4.1% (p < 0.001). The need for revision surgery is more frequent at 4% (p < 0.001). Aetiology of need for revision surgery included; periprosthestic infection (70%), aseptic loosening (13%), instability (13%), periprosthetic fracture (2%) and liner wear (2%). THA in patients with liver transplants seems to offer functional improvement; however, no studies have formally assessed functional outcomes in the patient with active CLD.Discussion: A multidisciplinary perioperative approach is suggested in order to minimize increased complication risks. Specific measures include optimizing haemoglobin and taking measures to reduce infection. This review also highlights gaps in available literature and guides future research to appraise functional outcomes, further detail long-term failure reasons and study any differences in outcomes and complications based on the range of operative approaches and available implant choices.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Total hip arthroplasty in patients with chronic liver disease: A systematic review

Onochie

Kayani

Dawson-Bowling

et al. 2019

SICOT-J

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The Impact of Hepatitis C and Liver Disease on Risk of Complications After Total Hip and Knee Arthroplasty: Analysis of Administrative Data From Louisiana and Texas

et al. 2021

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Background: Millions of Americans have hepatitis C and other liver diseases, many of whom have endstage osteoarthritis requiring total joint arthroplasty (TJA). This study aimed to determine the extent to which hepatitis C and other liver diseases are independent risk factors for complications, including readmission and reoperation, in patients undergoing TJA. Methods: Retrospective study of a REACHnet data set containing demographics, International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) codes, and clinical and laboratory data for patients who underwent primary total knee or hip replacement from 2013 to 2017 at 3 hospital systems in Louisiana and Texas. Multivariable logistic regression analyses examined predictors of complications. Any complication was defined as a 90-day medical complication or readmission or reoperation within 1 year. Results: Among 13,673 patients who met inclusion criteria, 14.9% (2044/13,673) had any complication, 11.7% (1600/13,673) were readmitted within 90 days, and 3.6% (497/13,673) had a reoperation within 1 year. Liver disease increased the odds for any complication (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.08-1.18), 90-day medical complication (OR, 1.13; 95% CI, 1.04-1.22), and 90-day readmission (OR, 1.11; 95% CI, 1.06-1.17). Hepatitis C was not, by itself, associated with an increase in any type of complication but was usually associated with liver disease. Comorbidity severity was the strongest predictor of all types of complications after TJA. Conclusion: Patients in Louisiana and Texas with liver disease were at increased risk for complications after TJA, corroborating findings of previous studies. Hepatitis C was not an independent predictor of complications because of its high association with liver disease.

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Patients With Moderate to Severe Liver Cirrhosis Have Significantly Higher Short-Term Complication Rates Following Total Knee Arthroplasty: A Retrospective Cohort Study

Lan,

Stiles,

Ward

et al. 2024

The Journal of Arthroplasty

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Outcome analysis of hip or knee arthroplasty in patients with cirrhotic liver disease

Cited by 14 publications

References 23 publications

Total hip arthroplasty in patients with chronic liver disease: A systematic review

Total hip arthroplasty in patients with chronic liver disease: A systematic review

The Impact of Hepatitis C and Liver Disease on Risk of Complications After Total Hip and Knee Arthroplasty: Analysis of Administrative Data From Louisiana and Texas

Patients With Moderate to Severe Liver Cirrhosis Have Significantly Higher Short-Term Complication Rates Following Total Knee Arthroplasty: A Retrospective Cohort Study

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