Outcomes Following Revision Joint Arthroplasty Among Hemodialysis-Dependent Patients

Labaran, Lawal; Sequeira, Sean B.; Bolarinwa, Surajudeen A.; Aryee, Jomar; Montgomery, Samuel R.; Nwankwo, Eugene; Haug, Emanuel; Bell, Joshua; Cui, Quanjun

doi:10.1016/j.arth.2019.10.041

Cited by 6 publications

(15 citation statements)

References 30 publications

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“…1 ). 2 – 5 , 10 – 27 If possible, the articles were then divided based on the site of arthroplasty surgery (TKA or THA) and the type of renal replacement therapy (dialysis vs. kidney transplant).…”

Section: Resultsmentioning

confidence: 99%

“…There were 16 studies ( n = 5353) that recorded the mortality rate after TJA. 2 , 4 , 5 , 10 – 14 , 16 – 19 , 21 , 22 , 26 , 27 The overall pooled mortality rate in dialysis-dependent and KT patients who received TJA was 14.9% (95% CI: 0.092–0.231). For patients who are under dialysis, the pooled mortality rate was 13.8% (95% CI: 0.067–0.264).…”

Section: Resultsmentioning

confidence: 99%

“…Several reports have discussed the mortality rate after TJA in this patient population. 2 , 4 , 5 , 10 – 14 , 16 – 19 , 21 , 22 , 26 , 27 In a case-control study performed by Erkocak et al, the authors noted a significantly higher odds ratio ( OR = 10.46) for in-hospital mortality in patients under dialysis in comparison with non-ESRD patients. 15 In the general population, the in-hospital mortality rate is relatively low, with an incidence of 0.13% and 0.18% after TKA and THA respectively.…”

Section: Discussionmentioning

confidence: 98%

“… 30 Upon reviewing 22 well-designed studies, we noted a relatively higher overall mortality (14.9%; CI: 0.092–0.231), SSC (3.4%; CI: 0.023–0.050) and PJI (3.9%; CI: 0.019–0.080) rate in patients with ESRD. 2 – 5 , 10 – 27 When evaluating the patients based on type of renal replacement therapy, there was an increase in mortality rate after TJA in patients under dialysis (13.8%; CI: 0.067–0.264) and patients who had previously received a KT (15.8%; CI: 0.083–0.281). Several reports have discussed the mortality rate after TJA in this patient population.…”

Section: Discussionmentioning

confidence: 99%

“… 4 The higher risk is most likely multi-factorial, including complex comorbidities, renal osteodystrophy leading to increased bone turnover, and beta 2-microglobulin deposition around the prosthesis. 5 For patients under dialysis, there may be a higher risk of haematogenous spread of bacteria, ultimately leading to prosthetic joint infections (PJI). For patients who received a kidney transplant, there is an increased risk of infection and implant loosening.…”

Section: Introductionmentioning

confidence: 99%

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Dialysis patients have comparable results to patients who have received kidney transplant after total joint arthroplasty: a systematic review and meta-analysis

et al. 2021

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Patients with end-stage renal disease (ESRD) have inferior outcomes after hip and knee total joint arthroplasty (TJA), with higher risk for surgical site complications (SSC) and periprosthetic joint infection (PJI). We conducted a systematic review and meta-analysis regarding outcomes after hip and knee TJA in ESRD patients who have received dialysis or a kidney transplant (KT) using PubMed, MEDLINE, Cochrane Reviews, and Embase in order to: (1) determine the mortality and infection rate of TJA in patients receiving dialysis or KT and (2) to identify risk factors associated with the outcome. We included 22 studies and 9384 patients (dialysis, n = 8921, KT, n = 463). The overall mortality rate was 14.9% and was slightly higher in KT patients (dialysis vs. KT, 13.8% vs. 15.8%). The overall SSC rate was 3.4%, while dialysis and KT patients each had an incidence of 3.3% and 3.6%, respectively. For PJI, the overall rate was 3.9%, while the incidence for dialysis patients was 4.0% and for KT patients was 3.7%. Using multi-regression analysis, age, sex, the type of arthroplasty (knee or hip) performed, and the form of renal replacement therapy (dialysis or KT) were not significant risk factors. In patients on dialysis or who had received a KT, TJA is associated with a slight increase in mortality, SSC and PJI rates. Cite this article: EFORT Open Rev 2021;6:618-628. DOI: 10.1302/2058-5241.6.200116

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Dialysis patients have comparable results to patients who have received kidney transplant after total joint arthroplasty: a systematic review and meta-analysis

et al. 2021

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Total hip arthroplasty complications in patients with chronic kidney disease: A comparison study

Fox

Domingue

DeMaio

et al. 2023

Journal of Orthopaedics

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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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Outcomes Following Revision Joint Arthroplasty Among Hemodialysis-Dependent Patients

Cited by 6 publications

References 30 publications

Dialysis patients have comparable results to patients who have received kidney transplant after total joint arthroplasty: a systematic review and meta-analysis

Dialysis patients have comparable results to patients who have received kidney transplant after total joint arthroplasty: a systematic review and meta-analysis

Total hip arthroplasty complications in patients with chronic kidney disease: A comparison study

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

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