Total knee arthroplasty in dialysis patients: Is it safe? A systematic review of the literature

Gkiatas, Ioannis; Xiang, William; Karasavvidis, Theofilos; Windsor, Eric N.; Sharma, Abhinav K.; Sculco, Peter K.

doi:10.1016/j.jor.2021.05.025

Cited by 7 publications

(8 citation statements)

References 39 publications

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Luo

Gong

Yang

2023

International Wound Journal

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A meta‐analysis study to assess the knee and hip arthroplasty joint surgical site wound infection (SSWI) in end‐stage renal disease (ESRD) subjects who underwent dialysis or a kidney transplant (KT). A comprehensive literature examination till February 2023 was implemented and 1046 linked studies were appraised. The picked studies contained 5 471 898 subjects with total joint arthroplasty (TJA) at the baseline, 13 049 of them were haemodialysis or renal transplant, and 5 458 849 were control. Odds ratio (OR) in addition to 95% confidence intervals (CIs) were used to calculate the consequence of knee and hip arthroplasty SSWI in ESRD subjects who underwent dialysis or a KT by the dichotomous and continuous styles and a fixed or random model. Haemodialysis or renal transplant had a significantly higher postoperative SSWI (OR, 2.13; 95% CI, 1.73–2.62, P < .001) compared with control in TJA subjects. However, no significant difference was observed between haemodialysis and renal transplant in postoperative SSWI (OR, 0.93; 95% CI, 0.16–5.54, P = .94) and between haemodialysis or renal transplant and control in prosthetic joint infection (OR, 1.07; 95% CI, 0.25–4.55, P = .93) in TJA subjects. Haemodialysis had a significantly higher prosthetic joint infection (OR, 1.92; 95% CI, 1.21–3.03, P = .005) compared with renal transplant in TJA subjects. Haemodialysis or renal transplant had a significantly higher postoperative SSWI in TJA subjects. Also, haemodialysis had a significantly higher prosthetic joint infection compared with renal transplant in TJA subjects. Although precautions should be taken when commerce with the consequences because a low number of selected studies was picked for certain comparisons in this meta‐analysis.

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Section: Discussionmentioning

confidence: 99%

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

Luo

Gong

Yang

2023

International Wound Journal

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Ding

2023

International Wound Journal

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A meta‐analysis study to measure the consequence of endoscopic loop ties (ELT) in acute appendicitis (AA) on wound infection rate. A comprehensive literature inspection till February 2023 was applied and 2765 interrelated studies were reviewed. The 27 chosen studies enclosed 15 093 subjects with AA in the chosen studies' starting point, 7141 of them were ELT, and 7952 were open surgery. Odds ratio (OR) in addition to 95% confidence intervals (CIs) were used to compute the value of the effect of ELT in AA on wound infection rate by the dichotomous and continuous styles and a fixed or random model. Open surgery had a significantly higher postoperative surgical site wound infection (SSWI). (OR, 1.41; 95% CI, 1.09–1.83, P = 0.009) with low heterogeneity (I2 = 34%) compared to ELT in AA subjects. Although no significant difference was detected between open surgery and ELT in intra‐abdominal abscess rate (OR, 0.88; 95% CI, 0.56–1.40, P = 0.59) with moderate heterogeneity (I2 = 51%) in AA subjects. Open surgery had a significantly higher postoperative SSWI, however, no significant difference was found in intra‐abdominal abscess rate compared to ELT in AA subjects. However, caused by the small sample sizes of several chosen studies for this meta‐analysis, care must be exercised when dealing with its values.

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“…Knee joint pain and limited range of motion can restrict walking and ADL, and knee joint replacement surgery may be considered. However, since the prognosis after knee replacement surgery is poor in hemodialysis patients [31]- [34], aggressive physical therapy aimed at preventing the severity of the disease is necessary from the early stage.…”

Section: Rehabilitation Approachmentioning

confidence: 99%

Gait Classification and Physical Function Characteristics in Maintenance Hemodialysis Patients

T¹,

Hatanaka²

2022

saj

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Only walking velocity has been reported as a performance measure of gait in hemodialysis patients, and no kinematic or kinetic analysis has been reported. We evaluated basic information, physical function, aging, dialysis-related complications, and gait in 23 outpatients (≥60 years old) who could walk independently. Hierarchical cluster analysis was performed using joint angles, joint moments, and gait parameters during gait. The gait of hemodialysis patients was classified into two clusters: Cluster 1 and Cluster 2. Cluster 1 gait showed a longer hemodialysis duration, higher dialysis amyloidosis severity, knee joint pain, lower ankle plantarflexion weakness, and lower extremity joint dysfunction than Cluster 2. The gait of Cluster 1 patients consisted of flexion of the knee joint, ankle joint, and trunk, and excessive knee joint flexion was observed in the stance phase to escape posterior knee joint pain. Cluster 1 patients were also unable to kick out sufficiently, and their walking rate and walking velocity were decreased. Cluster 2 patients had a shorter hemodialysis duration than Cluster 1. External forces exerted on the knee joint in the hyperextension direction during gait could cause pain and inflammation of the posterior knee joint.

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Total knee arthroplasty in dialysis patients: Is it safe? A systematic review of the literature

Cited by 7 publications

References 39 publications

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

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

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

Gait Classification and Physical Function Characteristics in Maintenance Hemodialysis Patients

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