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dc.contributor.authorHan, George J.
dc.contributor.authorDeren, Matthew E.
dc.date2022-08-11T08:08:27.000
dc.date.accessioned2022-08-23T15:55:51Z
dc.date.available2022-08-23T15:55:51Z
dc.date.issued2021-05-21
dc.date.submitted2021-08-02
dc.identifier.citation<p>Han GJ, Deren ME. A Complication Profile of Total Hip and Knee Arthroplasty in Liver Transplantation Patients: A Meta-Analysis. J Arthroplasty. 2021 May 21:S0883-5403(21)00506-4. doi: 10.1016/j.arth.2021.05.024. Epub ahead of print. PMID: 34127348. <a href="https://doi.org/10.1016/j.arth.2021.05.024">Link to article on publisher's site</a></p>
dc.identifier.issn0883-5403 (Linking)
dc.identifier.doi10.1016/j.arth.2021.05.024
dc.identifier.pmid34127348
dc.identifier.urihttp://hdl.handle.net/20.500.14038/29844
dc.description.abstractBACKGROUND: There is an increasing demand for total joint arthroplasty in liver transplantation patients. However, significant heterogeneity in existing studies creates difficulty to draw conclusions on the risk profile of arthroplasty in this population. METHODS: A systematic review of the literature dated from 1980 to 2020 describing the complication rates of liver transplantation patients receiving either total hip or knee arthroplasty was conducted. Multiple outcomes were extracted and a meta-analysis was performed. Four cohorts were created for analysis purposes: liver transplant patients undergoing THA and TKA (1), THA only (2), TKA only (3), and controls (4). RESULTS: A total of 13 studies were included in this meta-analysis, accounting for 3024 liver transplantation patients. The rate of infection (odds ratio [OR] = 2.14, OR = 1.61, OR = 2.52), myocardial infarction (OR = 1.65, OR = 1.75, OR = 1.57), respiratory failure (OR = 2.19, OR = 2.50, OR = 1.96), acute kidney injury (OR = 5.71, OR = 5.40, OR = 4.35), sepsis (OR = 3.72, OR = 3.30, OR = 4.02), and blood transfusions (OR = 2.09, OR = 3.65, OR = 1.74) were all significantly higher in the 3 cohorts compared to the controls. Revision/reoperation rates were significantly higher in cohorts 1 and 3 (OR = 1.52 and OR = 1.62, respectively). Patient-reported outcomes saw improvements in Harris Hip Score, objective Knee Society Score, and functional Knee Society Score postoperatively (average improvement = 32.4, 37.2, and 15.3, respectively). CONCLUSION: Liver transplantation patients functionally benefit from total hip and knee arthroplasty, but at the cost of increased risk of infection, revision/reoperation, and medically related complications compared to controls. Mortality may also be a short-term risk.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=34127348&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttps://doi.org/10.1016/j.arth.2021.05.024
dc.subjectarthroplasty
dc.subjectcomplications
dc.subjecthip
dc.subjectknee
dc.subjectliver
dc.subjecttransplantation
dc.subjectOrthopedics
dc.titleA Complication Profile of Total Hip and Knee Arthroplasty in Liver Transplantation Patients: A Meta-Analysis
dc.typeJournal Article
dc.source.journaltitleThe Journal of arthroplasty
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/faculty_pubs/2050
dc.identifier.contextkey24147010
html.description.abstract<p>BACKGROUND: There is an increasing demand for total joint arthroplasty in liver transplantation patients. However, significant heterogeneity in existing studies creates difficulty to draw conclusions on the risk profile of arthroplasty in this population.</p> <p>METHODS: A systematic review of the literature dated from 1980 to 2020 describing the complication rates of liver transplantation patients receiving either total hip or knee arthroplasty was conducted. Multiple outcomes were extracted and a meta-analysis was performed. Four cohorts were created for analysis purposes: liver transplant patients undergoing THA and TKA (1), THA only (2), TKA only (3), and controls (4).</p> <p>RESULTS: A total of 13 studies were included in this meta-analysis, accounting for 3024 liver transplantation patients. The rate of infection (odds ratio [OR] = 2.14, OR = 1.61, OR = 2.52), myocardial infarction (OR = 1.65, OR = 1.75, OR = 1.57), respiratory failure (OR = 2.19, OR = 2.50, OR = 1.96), acute kidney injury (OR = 5.71, OR = 5.40, OR = 4.35), sepsis (OR = 3.72, OR = 3.30, OR = 4.02), and blood transfusions (OR = 2.09, OR = 3.65, OR = 1.74) were all significantly higher in the 3 cohorts compared to the controls. Revision/reoperation rates were significantly higher in cohorts 1 and 3 (OR = 1.52 and OR = 1.62, respectively). Patient-reported outcomes saw improvements in Harris Hip Score, objective Knee Society Score, and functional Knee Society Score postoperatively (average improvement = 32.4, 37.2, and 15.3, respectively).</p> <p>CONCLUSION: Liver transplantation patients functionally benefit from total hip and knee arthroplasty, but at the cost of increased risk of infection, revision/reoperation, and medically related complications compared to controls. Mortality may also be a short-term risk.</p>
dc.identifier.submissionpathfaculty_pubs/2050
dc.contributor.departmentDepartment of Orthopedics and Rehabilitation


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