Shoulder arthroplasty following solid organ transplant: A systematic review and meta-analysis.

Autor: Patel AV; Department of Orthopaedics, The Ohio State Wexner Medical Center, 2835 Fred Taylor.Dr, Columbus, OH, USA., Duey AH; Department of Orthopaedics, Icahn School of Medicine-Mount Sinai Hospital, New York City, NY, USA., Stevens AJ; Department of Orthopaedics, The Ohio State Wexner Medical Center, 2835 Fred Taylor.Dr, Columbus, OH, USA., Vaghani PA; Department of Orthopaedics, The Ohio State Wexner Medical Center, 2835 Fred Taylor.Dr, Columbus, OH, USA., Cvetanovich GL; Department of Orthopaedics, The Ohio State Wexner Medical Center, 2835 Fred Taylor.Dr, Columbus, OH, USA., Bishop JY; Department of Orthopaedics, The Ohio State Wexner Medical Center, 2835 Fred Taylor.Dr, Columbus, OH, USA., Rauck RC; Department of Orthopaedics, The Ohio State Wexner Medical Center, 2835 Fred Taylor.Dr, Columbus, OH, USA.
Jazyk: angličtina
Zdroj: Journal of orthopaedics [J Orthop] 2022 Nov 26; Vol. 35, pp. 150-154. Date of Electronic Publication: 2022 Nov 26 (Print Publication: 2023).
DOI: 10.1016/j.jor.2022.11.015
Abstrakt: Introduction: The purpose of this study is to report a systematic review and meta-analysis of solid organ transplant (SOT) patients undergoing shoulder arthroplasty to compare functional and radiographic outcomes, demographics, and complications with non-transplant patients.
Methods: Studies were included if they examined patients undergoing shoulder arthroplasty in the setting of prior solid organ transplantation and included post operative range of motion, patient-reported outcomes, complications, or revisions. Studies were excluded if they were national database analyses or lacked clinical data. Pubmed, MEDLine, Scopus, and Web of Science were queried using relevant search terms in July 2022. Data was pooled, weighted, and a paired t -test and chi-square analysis was performed.
Results: There were 71 SOT and 159 non-SOT shoulders included in the study. The most common indication for surgery was avascular necrosis (n = 26) in the solid organ transplant group and osteoarthritis (n = 60) in the non-SOT group. Forward elevation, external rotation, ASES, and VAS pain scores improved significantly in both cohorts following surgery. There was no significant difference in age at surgery (p-value = 0.20), postoperative forward elevation (p-value = 0.08), postoperative external rotation (0.84), and postoperative ASES scores (p-value = 0.11) between the two cohorts. VAS pain scores were significantly lower in the SOT cohort (p-value<0.01). The risk of death was significantly higher in the SOT group (p-value<0.01). but the rate of overall complications (p = 0.47), surgical complication (p-value = 0.79), or revision surgery (p-value = 1.00) was not significantly different between the two cohorts.
Conclusion: Shoulder arthroplasty is a safe, effective option in patients following solid organ transplant. There is not an increased risk of adverse outcomes, and SOT patients had comparable range of motion and patient-reported outcomes when compared to their non-SOT peers.
Level of Evidence: III.
Competing Interests: None.
(© 2022 Published by Elsevier B.V. on behalf of Professor P K Surendran Memorial Education Foundation.)
Databáze: MEDLINE
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