Ledford Cameron K, Chalmers Brian P, Statz Joseph M, Perry Kevin I, Mabry Tad M, Hanssen Arlen D, Abdel Matthew P
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
J Arthroplasty. 2017 Jan;32(1):101-105. doi: 10.1016/j.arth.2016.07.018. Epub 2016 Jul 25.
Clinical outcomes remain largely unknown beyond perioperative and short-term follow-up of solid organ transplant (SOT) patients undergoing total knee arthroplasty (TKA).
Patient mortality, implant survivorship, and complications of 96 TKAs (76 patients) after SOT were retrospectively reviewed through an internal joint registry. Mean age at index arthroplasty was 66 years, and mean follow-up was 4 years.
Overall mortality rates at 1 year, 2 years, and 5 years from TKA were 2.6%, 7.9%, and 13.2%, respectively, and combined SOT patient survivorship was 92% at 2 years and 82% at 5 years. Implant survivorship free of any component revision or implant removal was 98% at 2 years and 93% at 5 years. There was a high rate of perioperative complications (12.5%), including periprosthetic fractures (5.2%) and deep periprosthetic infection (3.2%).
TKA does not appear to have any effect on SOT patient survivorship following the procedure. However, SOT patients may have a higher risk of perioperative complications and a lower implant survivorship than the general population of TKA patients at midterm follow-up.
对于接受全膝关节置换术(TKA)的实体器官移植(SOT)患者,围手术期及短期随访后的临床结局在很大程度上仍不明确。
通过内部关节登记系统对96例SOT术后TKA(76例患者)的患者死亡率、植入物存活率及并发症进行回顾性分析。初次关节置换时的平均年龄为66岁,平均随访时间为4年。
TKA术后1年、2年和5年的总死亡率分别为2.6%、7.9%和13.2%,SOT患者的联合存活率在2年时为92%,在5年时为82%。无任何部件翻修或植入物取出的植入物存活率在2年时为98%,在5年时为93%。围手术期并发症发生率较高(12.5%),包括假体周围骨折(5.2%)和深部假体周围感染(3.2%)。
TKA术后似乎对SOT患者的存活率没有任何影响。然而,在中期随访中,SOT患者围手术期并发症的风险可能更高,植入物存活率低于TKA患者的一般人群。