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Outcomes of total hip arthroplasty surgery in heart and lung transplant recipients

journal contribution
posted on 31.03.2021, 06:26 by Filip Cosic, Lara Kimmel, Rejith Valsalan, Kathryn Hayes, Susan Liew
© 2019 Royal Australasian College of Surgeons Background: Traditionally, arthroplasty in heart and lung transplant patients has been undertaken to manage transplant-related complications. More recently, arthroplasty is increasingly being performed for end-stage osteoarthritis. This study reviewed short-term outcomes and complications of total hip arthroplasty (THA) in heart and lung transplant recipients. Methods: A retrospective cohort of heart and lung transplant recipients who underwent THA was identified using ICD-10 coding. Post-operative complications and hospital outcomes were collected using the patient medical record. Results: Thirteen patients underwent 17 primary THA between 2008 and 2017, including five for osteoarthritis and 12 for femoral head avascular necrosis. Of the 13 patients, nine were bilateral sequential lung transplant recipients and four were orthotopic heart transplant recipients. The mean patient age was 61 years, with nine being male. Overall, five patients had one post-operative complication with eight having two or more complications. Surgical complications included three intraoperative fractures, three patients with superficial infection and one with deep infection requiring surgery. Seven patients had significant bleeding requiring blood transfusion. Prosthetic dislocations occurred in two patients, with one patient requiring revision surgery (developing a joint infection). Other complications included one pulmonary embolism, two episodes of pneumonia and six episodes of acute kidney injury, whilst three patients developed post-operative delirium. At 6-week follow-up, five patients had ongoing pain and seven had limitations with mobility. At 12-month follow-up, three patients reported ongoing pain. Conclusion: Complications following THA after transplant are common. The risks and benefits of THA should be carefully considered preoperatively in this cohort.

History

Publication Date

01/01/2019

Journal

ANZ Journal of Surgery

Volume

89

Issue

6

Pagination

4p. (p. 729-732)

Publisher

Wiley-Blackwell

ISSN

1445-1433

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The Author reserves all moral rights over the deposited text and must be credited if any re-use occurs. Documents deposited in OPAL are the Open Access versions of outputs published elsewhere. Changes resulting from the publishing process may therefore not be reflected in this document. The final published version may be obtained via the publisher’s DOI. Please note that additional copyright and access restrictions may apply to the published version.

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