How Do Previous Solid Organ Transplant Recipients Fare After Primary Total Knee Arthroplasty?
J Arthroplasty
; 31(3): 609-15.e1, 2016 Mar.
Article
em En
| MEDLINE
| ID: mdl-26639984
ABSTRACT
INTRODUCTION:
Total knee arthroplasty (TKA) has been proven to increase knee outcome scores after solid organ transplantation (SOT), but many authors are concerned about a higher complication rate. The purpose of this study is to evaluate the complication profile of TKA after previous SOT.METHODS:
A search of the entire Medicare database from 2005 to 2011 was performed using International Classification of Disease, version 9, codes to identify 3339 patients who underwent TKA after 1 or more solid organ transplants including the kidney (2321), liver (772), lung (129), heart (412), and pancreas (167). A cohort of 1,685,295 patients served as a control with minimum 2-year follow-up. Postoperative complications at 30-day, 90-day, and overall time points were compared between the 2 cohorts.RESULTS:
Patients with any SOT were younger (age <65, odds ratio [OR] 6.58, P < .001), male (OR 1.88, P < .001), and medically complex (significant increase in 28 of 29 Elixhauser comorbidities, P < .05). There was a significant increase (P < .05) in 11 of 13 (84.6%) recorded postoperative medical complications rates at 90 days. There was a significant increase overall in periprosthetic infection (OR 2.11, P < .001), periprosthetic fracture (OR 1.78, P < .001), and TKA revision (OR 1.36, P < .001). When analyzed by individual organ, heart and lung transplants carried the fewest medical and surgical complications.CONCLUSION:
The results of this study demonstrate that patients with previous SOT who undergo elective primary TKA have more postoperative complications in the global period and at short-term follow-up. Yet, complication profiles by individual organ varied significantly.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Transplante de Órgãos
/
Artroplastia do Joelho
/
Transplantados
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Arthroplasty
Assunto da revista:
ORTOPEDIA
Ano de publicação:
2016
Tipo de documento:
Article