Total Hip and Knee Arthroplasty in Solid Organ Transplant Patients: Perioperative Optimization and Outcomes.
| Autor: | Ledford CK; From the Department of Orthopedic Surgery (Ledford, Barry, and Sherman), and the Department of Nephrology and Hypertension (Prendergast), Mayo Clinic, Jacksonville, FL., Barry KS, Prendergast MB, Sherman CE |
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| Jazyk: | angličtina |
| Zdroj: | The Journal of the American Academy of Orthopaedic Surgeons [J Am Acad Orthop Surg] 2022 Dec 15; Vol. 30 (24), pp. 1157-1164. Date of Electronic Publication: 2022 Oct 14. |
| DOI: | 10.5435/JAAOS-D-22-00370 |
| Abstrakt: | The success of renal, liver, cardiac, pulmonary, and other solid organ transplantation (SOT) has resulted in increasing volume of transplant procedures and recipient survivorship. Subsequently, many SOT patients develop end-stage degenerative joint disease and are presenting for total hip or total knee arthroplasty more frequently. Surgeons must be aware of the medical complexities and prepare for the perioperative risks associated with these immunocompromised patients. Preoperative evaluation should be conducted in coordination with transplant specialists to ensure optimization, including appropriate surgical timing and advanced, organ-specific medical assessments. Although often unable to be modified, the transplant patient's antirejection medication regimens should be reviewed with understanding of inherent risks of poor wound healing or acute infection. Despite higher rates of complications, revision surgeries, and mortality compared with the general population, SOT recipients continue to demonstrate markedly improved pain relief, function, and quality of life. An ongoing multidisciplinary approach is required throughout the perioperative process and beyond to deliver successful outcomes after total joint arthroplasty in the SOT population. (Copyright © 2022 by the American Academy of Orthopaedic Surgeons.) |
| Databáze: | MEDLINE |
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