The mid-term outcome of dialysis-dependent patients undergoing primary total knee arthroplasty and total hip arthroplasty: A retrospective study

J Chin Med Assoc. 2019 Feb;82(2):143-147. doi: 10.1097/JCMA.0000000000000017.

Abstract

Background: Dialysis-dependent patients undergoing primary total knee and total hip arthroplasty have been associated with higher in-hospital mortality and complication rates. We investigated the mid-term implant survival, patient survival, and functional outcomes in these patients and reviewed our complications.

Methods: We retrospectively reviewed dialysis-dependent patients undergoing primary total knee or total hip arthroplasty in our hospital between November 2004 and January 2015, with a minimum follow-up of 24 months. Thirty-four patients with 39 total knee arthroplasties were included (M:F, 33.3%:66.7%, mean age: 68.8 years, mean follow-up: 55.9 ± 28.3 months). Twenty-seven patients with 31 total hip arthroplasties were included (M:F, 22.6%:77.4%, mean age: 62.3 years, mean follow-up: 55.8 ± 23.4 months).

Results: In the total knee arthroplasty group, there were two in-hospital mortality cases (3.5%) and two cases of implant failure (5.1%). The mean Knee Society Score was 84.0 ± 20.7. In the total hip arthroplasty group, there were three cases of implant failure (9.7%). The mean Harris Hip Score was 81.1 ± 23.9. The complications we encountered for both groups were instability and infection.

Conclusion: Dialysis-dependent patients who had undergone total joint arthroplasty are associated with high mortality rate. In our experience, satisfactory mid-term results can be achieved in these patients with manageable complications and low-implant failure rates.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip* / adverse effects
  • Arthroplasty, Replacement, Hip* / mortality
  • Arthroplasty, Replacement, Knee* / adverse effects
  • Arthroplasty, Replacement, Knee* / mortality
  • Female
  • Hospital Mortality
  • Humans
  • Male
  • Middle Aged
  • Renal Dialysis*
  • Retrospective Studies