Outcomes of primary total joint arthroplasty in patients with a history of solid organ transplantation, a single institution analysis

Background: An increasing number of patients with a history of solid organ transplantation (SOT) are presenting for total joint arthroplasty (TJA). The primary aim of this study is to evaluate clinical outcomes after primary total joint arthroplasty in patients with a history of SOT compared to matched controls. Methods: We performed a review of prospectively collected data on consecutive adult patients with a history of SOT undergoing TJA from January 2014 to January 2021. Pearson-Chi square tests were used to compare differences in baseline demographics and clinical characteristics between SOT and matched controls. Multi-variate logistic regression analyses were used to assess whether patients who had a prior SOT were at higher risk of experiencing post-operative complications, readmissions, reoperations, longer length of stay and non-home discharges after primary TJA. Results: A total of 81 operations met inclusion criteria which were compared to 82 age matched controls without a history of SOT. Patients with a history of SOT were more likely to require a hospitalization greater than 2 days compared to the control group (n=63, 77.8% vs. n=16, 19.5%; P=0.011), had an increased risk of hyperkalemia (n=15, 18.5% vs. n=1, 1.2%; P=0.049), and any post-operative complication (n=55, 67.9% vs. n=21, 25.6%; P=0.025). Conclusions: Despite the increased risk of acute post-operative complications and longer hospital stays, primary TJA has been shown to be a safe and effective option for treatment of DJD or AVN in patients with a history of SOT when completed via a multi-disciplinary approach. Level of Evidence: Retrospective Analysis, Level IV.