Revision Joint Arthroplasty and Renal Transplant: A Matched Control Cohort Study

Labaran, Lawal; Amin, Raj M.; Bolarinwa, Surajudeen A.; Puvanesarajah, Varun; Rao, Sandesh S.; Browne, James A.; Werner, Brian C.

doi:10.1016/j.arth.2019.08.045

Cited by 13 publications

(11 citation statements)

References 23 publications

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“…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]. Each reoperation and complication in this SOT cohort was of separate, indistinguishable etiologies, including only one superficial infection successfully treated with debridement and no further sequelae.…”

Section: Discussionmentioning

confidence: 78%

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: 78%

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

et al. 2021

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“…reported no difference in 90-day major medical complications in patients with history of renal transplant undergoing revision arthroplasty compared to matched controls. [ 10 ] In a single institution review, Brown et al. also found no difference in peri-operative complications comparing SOT patients and matched controls who underwent primary total joint arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

“…The primary advantages of this study are the large sample size and stratified outcome analysis based on indication for revision. To date, only one other report has used a national administrative database to analyze outcomes of revision arthroplasty in transplant patients [ 10 ], but the number of patients analyzed was smaller and aseptic and infected revisions were considered jointly. We believe this may obscure important differences when considering the post-operative risks faced by this unique group of patients.…”

Section: Discussionmentioning

confidence: 99%

“…[21] Prior studies on rTHA in SOT patients are limited. Labaran et al investigated outcomes after revision hip and knee arthroplasty in renal transplant patients using a large Medicare database from 2005 to 2015 [10]. In a matched analysis they found that renal transplant patients (total 661 patients) had an increased 90-day readmission (27.8% vs 23.2%), 90-day septicemia and 1-year mortality (6.8% vs 2.3%) rates than matched non-transplant patients; they found no difference in LOS or 1-year infection rates between group.…”

Section: Discussionmentioning

confidence: 99%

“…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 performed a study using a national administrative database and identified 661 rTHAs performed specifically in renal transplant recipients and found an increased risk of 90-day hospital readmission, 1-year septicemia, and 1-year mortality compared to matched controls [10]. Unfortunately, there are no currently available data in the literature which stratify outcomes based on aseptic vs infected revisions, which has been shown to influence the risk for 30-day complications after arthroplasty [11,12].…”

Section: Introductionmentioning

confidence: 99%

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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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Joint Replacement Surgery Comparing Patients with End-Stage Renal Disease and Post Kidney Transplant

Dodin

Parajuli

2022

Complications in Kidney Transplantation

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Revision Joint Arthroplasty and Renal Transplant: A Matched Control Cohort Study

Cited by 13 publications

References 23 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

Joint Replacement Surgery Comparing Patients with End-Stage Renal Disease and Post Kidney Transplant

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