Mid-term clinical outcomes and complications of primary total knee arthroplasty in hemodialysis patients: a retrospective comparative cohort study

Abstract Background Numerous patients who receive hemodialysis (HD) undergo total knee arthroplasty (TKA) due to advanced knee joint arthritis. However, there are few studies that describe the clinical outcomes and complications of TKA in HD patients. This study investigated the mid-term results of...

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Autores principales:	Sakumo Kii, Motoki Sonohata, Akira Hashimoto, Takema Nakashima, Atsushi Kawaguchi, Yosuke Matsumura, Takafumi Shimazaki, Satomi Nagamine, Masaaki Mawatari
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Hemodialysis Total knee arthroplasty Propensity score matching American knee society score Complications Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/ffd162e2c781447c8f2868da6f22cf21
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spelling	oai:doaj.org-article:ffd162e2c781447c8f2868da6f22cf212021-11-08T10:58:27ZMid-term clinical outcomes and complications of primary total knee arthroplasty in hemodialysis patients: a retrospective comparative cohort study10.1186/s12891-021-04810-81471-2474https://doaj.org/article/ffd162e2c781447c8f2868da6f22cf212021-11-01T00:00:00Zhttps://doi.org/10.1186/s12891-021-04810-8https://doaj.org/toc/1471-2474Abstract Background Numerous patients who receive hemodialysis (HD) undergo total knee arthroplasty (TKA) due to advanced knee joint arthritis. However, there are few studies that describe the clinical outcomes and complications of TKA in HD patients. This study investigated the mid-term results of TKA in patients undergoing HD. Methods This single-center retrospective study compared clinical and surgical outcomes following TKA in patients who were receiving HD with those who were not. We used propensity scores to match 21 knees of 18 patients who received HD to 706 knees of 569 patients who had not received HD, from a total of 727 knees (587 patients) that underwent primary unilateral TKA. The clinical outcomes were evaluated using the American Knee Society Score-knee (AKSS-knee) and AKSS-function scores. The primary surgical outcome measure was the number of knees with postoperative complications. Results In both the HD and non-HD groups, postoperative AKSS-knee and function scores significantly improved when compared to preoperative values. Postoperative AKSS-knee and function scores were not significantly different between the groups. The number of knees with postoperative complications was larger in the HD group than the non-HD group within the first postoperative month, 0–12 months, 12–24 months, 0–24 months, and two years after surgery. Additionally, in the HD group, more complications occurred in the first month than any subsequent month in the two years after surgery. Conclusions TKA improves AKSS-knee and function scores equivalently for HD patients and non-HD patients. However, HD patients develop more complications after TKA, especially within the first month. Therefore, surgeons who perform TKA for HD patients should obtain informed consent after explaining the possible complications, and HD patients should be carefully observed following TKA.Sakumo KiiMotoki SonohataAkira HashimotoTakema NakashimaAtsushi KawaguchiYosuke MatsumuraTakafumi ShimazakiSatomi NagamineMasaaki MawatariBMCarticleHemodialysisTotal knee arthroplastyPropensity score matchingAmerican knee society scoreComplicationsDiseases of the musculoskeletal systemRC925-935ENBMC Musculoskeletal Disorders, Vol 22, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Hemodialysis Total knee arthroplasty Propensity score matching American knee society score Complications Diseases of the musculoskeletal system RC925-935
spellingShingle	Hemodialysis Total knee arthroplasty Propensity score matching American knee society score Complications Diseases of the musculoskeletal system RC925-935 Sakumo Kii Motoki Sonohata Akira Hashimoto Takema Nakashima Atsushi Kawaguchi Yosuke Matsumura Takafumi Shimazaki Satomi Nagamine Masaaki Mawatari Mid-term clinical outcomes and complications of primary total knee arthroplasty in hemodialysis patients: a retrospective comparative cohort study
description	Abstract Background Numerous patients who receive hemodialysis (HD) undergo total knee arthroplasty (TKA) due to advanced knee joint arthritis. However, there are few studies that describe the clinical outcomes and complications of TKA in HD patients. This study investigated the mid-term results of TKA in patients undergoing HD. Methods This single-center retrospective study compared clinical and surgical outcomes following TKA in patients who were receiving HD with those who were not. We used propensity scores to match 21 knees of 18 patients who received HD to 706 knees of 569 patients who had not received HD, from a total of 727 knees (587 patients) that underwent primary unilateral TKA. The clinical outcomes were evaluated using the American Knee Society Score-knee (AKSS-knee) and AKSS-function scores. The primary surgical outcome measure was the number of knees with postoperative complications. Results In both the HD and non-HD groups, postoperative AKSS-knee and function scores significantly improved when compared to preoperative values. Postoperative AKSS-knee and function scores were not significantly different between the groups. The number of knees with postoperative complications was larger in the HD group than the non-HD group within the first postoperative month, 0–12 months, 12–24 months, 0–24 months, and two years after surgery. Additionally, in the HD group, more complications occurred in the first month than any subsequent month in the two years after surgery. Conclusions TKA improves AKSS-knee and function scores equivalently for HD patients and non-HD patients. However, HD patients develop more complications after TKA, especially within the first month. Therefore, surgeons who perform TKA for HD patients should obtain informed consent after explaining the possible complications, and HD patients should be carefully observed following TKA.
format	article
author	Sakumo Kii Motoki Sonohata Akira Hashimoto Takema Nakashima Atsushi Kawaguchi Yosuke Matsumura Takafumi Shimazaki Satomi Nagamine Masaaki Mawatari
author_facet	Sakumo Kii Motoki Sonohata Akira Hashimoto Takema Nakashima Atsushi Kawaguchi Yosuke Matsumura Takafumi Shimazaki Satomi Nagamine Masaaki Mawatari
author_sort	Sakumo Kii
title	Mid-term clinical outcomes and complications of primary total knee arthroplasty in hemodialysis patients: a retrospective comparative cohort study
title_short	Mid-term clinical outcomes and complications of primary total knee arthroplasty in hemodialysis patients: a retrospective comparative cohort study
title_full	Mid-term clinical outcomes and complications of primary total knee arthroplasty in hemodialysis patients: a retrospective comparative cohort study
title_fullStr	Mid-term clinical outcomes and complications of primary total knee arthroplasty in hemodialysis patients: a retrospective comparative cohort study
title_full_unstemmed	Mid-term clinical outcomes and complications of primary total knee arthroplasty in hemodialysis patients: a retrospective comparative cohort study
title_sort	mid-term clinical outcomes and complications of primary total knee arthroplasty in hemodialysis patients: a retrospective comparative cohort study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/ffd162e2c781447c8f2868da6f22cf21
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Mid-term clinical outcomes and complications of primary total knee arthroplasty in hemodialysis patients: a retrospective comparative cohort study

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