title: Post-operative medical and surgical complications after primary total joint arthroplasty in solid organ transplant recipients: a case series.
abstract: In a series of solid organ transplant (SOT) recipients who underwent a subsequent primary total joint arthroplasty (TJA) procedure, this study aimed to determine: (1) 90-day morbidity and mortality after primary total knee or hip arthroplasty (TKA and THA), (2) overall post-operative infection rates, and (3) how complication and infection rates compared across primary TJA procedure and type of transplant organ.
  
  
  
  The University of Michigan Health System database was retrospectively searched using current procedural terminology codes for any primary TKA or THA performed at the institution in years 2000-2012 in a patient who previously received a successful SOT at any hospital.
  
  
  
  The search yielded 44 arthroplasties performed in 29 SOT recipients (average age 54.8 years, average follow-up about 30 months for both groups). No deaths were reported, but 13/27 (48.1%) THA patients and 2/6 (33.3%) TKA patients experienced a total of 29 complications within 90 days of surgery. One patient (3.7%) [1/27 patients, 1/37 joints] underwent revision hip arthroplasty to correct limb length. One THA patient and two TKA patients developed infection requiring revision surgery (3.7% and 33%, respectively). Type of transplant did not affect complication rates (P=0.65), and infection was more common after TKA (P=0.01).
  
  
  
  A series of SOT recipients demonstrated increased rates of infection and other complications following TJA. Surgical and medical teams should work closely to optimize this population for TJA surgery and minimize peri-operative complications.
  
  
  
  Level IV, Prognostic Case-Series.
authors: Department of Orthopaedic Surgery - Adult Reconstruction, University of Michigan Medical School, 2912 Taubman Center, 1500 E. Medical Center Drive, SPC 5328, Ann Arbor, MI, 48109, USA.
authors: Andrew C
authors: AC
authors: Palmisano
authors: Department of Orthopaedic Surgery - Adult Reconstruction, University of Michigan Medical School, 2912 Taubman Center, 1500 E. Medical Center Drive, SPC 5328, Ann Arbor, MI, 48109, USA.
authors: Andrew W
authors: AW
authors: Kuhn
authors: Department of Orthopaedic Surgery - Adult Reconstruction, University of Michigan Medical School, 2912 Taubman Center, 1500 E. Medical Center Drive, SPC 5328, Ann Arbor, MI, 48109, USA.
authors: Andrew G
authors: AG
authors: Urquhart
authors: Department of Orthopaedic Surgery - Adult Reconstruction, University of Michigan Medical School, 2912 Taubman Center, 1500 E. Medical Center Drive, SPC 5328, Ann Arbor, MI, 48109, USA. aeslampo@med.umich.edu.
authors: Aidin Eslam
authors: AE
authors: Pour
mesh_terms: D000368:Aged; D019643:Arthroplasty, Replacement / Q000009:adverse effects*; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012086:Reoperation / Q000009:adverse effects; D012189:Retrospective Studies; D066027:Transplant Recipients / Q000706:statistics & numerical data*
keywords: Complications; Hip arthroplasty; Infection; Knee arthroplasty; Organ transplant; Total joint arthroplasty