Risk versus reward: total joint arthroplasty outcomes after various solid organ transplantations.
Clinical outcomes were retrospectively reviewed for 76 primary total hip (THA) and total knee arthroplasties (TKA) performed after kidney, liver, cardiac, and lung transplantation with follow-up of 30.2 and 41.2 months, respectively. For the THA and TKA cohorts, there were a high rate of medical complications (29% and 33%), increased hospital length of stay (4.2 and 3.7 days), and more reoperations (7.2% and 9.1%). Only 1 (1.8%) periprosthetic infection was documented for THAs but 3 (14.2%) TKAs required two-stage revisions for infection. All transplant cohorts demonstrated significant increases (P < 0.05) in HHS and KSS scores with majority of patients reporting overall good or excellent outcomes (82%-100%). These results suggest that various organ transplant patients may accept higher surgical risks for rewarding outcomes.
Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
Cameron K
CK
Ledford
Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
Tyler Steven
TS
Watters
Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
Samuel S
SS
Wellman
Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
David E
DE
Attarian
Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
Michael P
MP
Bolognesi
D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D015897:Comorbidity; D016027:Heart Transplantation / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D016031:Liver Transplantation / Q000706:statistics & numerical data; D016040:Lung Transplantation / Q000706:statistics & numerical data; D008875:Middle Aged; D016377:Organ Transplantation / Q000706:statistics & numerical data*; D015207:Osteoarthritis, Hip / Q000453:epidemiology / Q000601:surgery*; D020370:Osteoarthritis, Knee / Q000453:epidemiology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors
complications; functional outcomes; hip arthroplasty; knee arthroplasty; solid organ transplantation