Outcomes of Femoral Neck Fracture Treated With Hip Arthroplasty in Solid Organ Transplant Patients

Background: Solid organ transplant (SOT) patients have increased risk of complications, infection, and mortality after elective total hip arthroplasty (THA). The study aims to compare SOT recipients' clinical outcomes to a matched group of nontransplant patients after nonelective THA and hemiar...

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Autores principales:	Cameron K. Ledford, MD, Michael J. VanWagner, DO, Aaron C. Spaulding, PhD, Luke S. Spencer-Gardner, MD, Benjamin K. Wilke, MD, Steven B. Porter, MD
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Solid organ transplant Femoral neck fracture Hemiarthroplasty Total hip arthroplasty Complications Readmission Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/8fd3a8ee882348049aea3c5c6a7ed9db
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spelling	oai:doaj.org-article:8fd3a8ee882348049aea3c5c6a7ed9db2021-11-14T04:34:09ZOutcomes of Femoral Neck Fracture Treated With Hip Arthroplasty in Solid Organ Transplant Patients2352-344110.1016/j.artd.2021.09.006https://doaj.org/article/8fd3a8ee882348049aea3c5c6a7ed9db2021-10-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2352344121001692https://doaj.org/toc/2352-3441Background: Solid organ transplant (SOT) patients have increased risk of complications, infection, and mortality after elective total hip arthroplasty (THA). The study aims to compare SOT recipients' clinical outcomes to a matched group of nontransplant patients after nonelective THA and hemiarthroplasty for acute femoral neck fracture (FNF). Methods: A retrospective review identified 31 SOT patients undergoing hip arthroplasty (24 hemiarthroplasty and 7 THA) for FNF and were matched 1:1 to non-SOT patients based on age, sex, body mass index, surgical procedure, and year of surgery. Patient survivorship, perioperative outcomes, complications, and reoperations were compared. The mean follow-up was 3 years. Results: The estimated survivorship free from mortality for SOT and non-SOT patients at 1- year was not different (77% and 84%, respectively, P = .52). The 90-day readmission rate was significantly higher with 8 (26%) in the SOT cohort and none in the non-SOT group (P < .01). Major medical complications occurred in 16% of SOT patients compared to 5% in controls (P = .21). Three (10%) reoperations/revisions were required for SOT patients and none in non-SOT group (P = .24). Conclusion: SOT recipients undergoing nonelective hip arthroplasty for FNF demonstrated increased readmission rates compared to matched controls. For this rare clinical scenario, diligent perioperative care by surgeons and multidisciplinary transplant specialists is necessary to mitigate increased risk of SOT patients.Cameron K. Ledford, MDMichael J. VanWagner, DOAaron C. Spaulding, PhDLuke S. Spencer-Gardner, MDBenjamin K. Wilke, MDSteven B. Porter, MDElsevierarticleSolid organ transplantFemoral neck fractureHemiarthroplastyTotal hip arthroplastyComplicationsReadmissionOrthopedic surgeryRD701-811ENArthroplasty Today, Vol 11, Iss , Pp 212-216 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Solid organ transplant Femoral neck fracture Hemiarthroplasty Total hip arthroplasty Complications Readmission Orthopedic surgery RD701-811
spellingShingle	Solid organ transplant Femoral neck fracture Hemiarthroplasty Total hip arthroplasty Complications Readmission Orthopedic surgery RD701-811 Cameron K. Ledford, MD Michael J. VanWagner, DO Aaron C. Spaulding, PhD Luke S. Spencer-Gardner, MD Benjamin K. Wilke, MD Steven B. Porter, MD Outcomes of Femoral Neck Fracture Treated With Hip Arthroplasty in Solid Organ Transplant Patients
description	Background: Solid organ transplant (SOT) patients have increased risk of complications, infection, and mortality after elective total hip arthroplasty (THA). The study aims to compare SOT recipients' clinical outcomes to a matched group of nontransplant patients after nonelective THA and hemiarthroplasty for acute femoral neck fracture (FNF). Methods: A retrospective review identified 31 SOT patients undergoing hip arthroplasty (24 hemiarthroplasty and 7 THA) for FNF and were matched 1:1 to non-SOT patients based on age, sex, body mass index, surgical procedure, and year of surgery. Patient survivorship, perioperative outcomes, complications, and reoperations were compared. The mean follow-up was 3 years. Results: The estimated survivorship free from mortality for SOT and non-SOT patients at 1- year was not different (77% and 84%, respectively, P = .52). The 90-day readmission rate was significantly higher with 8 (26%) in the SOT cohort and none in the non-SOT group (P < .01). Major medical complications occurred in 16% of SOT patients compared to 5% in controls (P = .21). Three (10%) reoperations/revisions were required for SOT patients and none in non-SOT group (P = .24). Conclusion: SOT recipients undergoing nonelective hip arthroplasty for FNF demonstrated increased readmission rates compared to matched controls. For this rare clinical scenario, diligent perioperative care by surgeons and multidisciplinary transplant specialists is necessary to mitigate increased risk of SOT patients.
format	article
author	Cameron K. Ledford, MD Michael J. VanWagner, DO Aaron C. Spaulding, PhD Luke S. Spencer-Gardner, MD Benjamin K. Wilke, MD Steven B. Porter, MD
author_facet	Cameron K. Ledford, MD Michael J. VanWagner, DO Aaron C. Spaulding, PhD Luke S. Spencer-Gardner, MD Benjamin K. Wilke, MD Steven B. Porter, MD
author_sort	Cameron K. Ledford, MD
title	Outcomes of Femoral Neck Fracture Treated With Hip Arthroplasty in Solid Organ Transplant Patients
title_short	Outcomes of Femoral Neck Fracture Treated With Hip Arthroplasty in Solid Organ Transplant Patients
title_full	Outcomes of Femoral Neck Fracture Treated With Hip Arthroplasty in Solid Organ Transplant Patients
title_fullStr	Outcomes of Femoral Neck Fracture Treated With Hip Arthroplasty in Solid Organ Transplant Patients
title_full_unstemmed	Outcomes of Femoral Neck Fracture Treated With Hip Arthroplasty in Solid Organ Transplant Patients
title_sort	outcomes of femoral neck fracture treated with hip arthroplasty in solid organ transplant patients
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/8fd3a8ee882348049aea3c5c6a7ed9db
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Outcomes of Femoral Neck Fracture Treated With Hip Arthroplasty in Solid Organ Transplant Patients

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