• 1. 

    Shukla R, Singh M & Jain RK et al.: Functional outcome of bipolar prosthesis versus total hip replacement in the treatment of femoral neck fracture in elderly patients. Malays Orthop J 11: 1, 2017.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 2. 

    Miric A, Inacio MCS & Namba RS: Can total knee arthroplasty be safely performed in patients with chronic renal disease? Acta Orthop 85: 71, 2014.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 3. 

    Sharma V, Awasthi B & Kumar K et al.: Outcome analysis of hemiarthroplasty vs. total hip replacement in displaced femoral neck fractures in the elderly. J Clin Diagn Res 10: RC11, 2016.

    • Search Google Scholar
    • Export Citation
  • 4. 

    Li Q, Dai B & Yao Y et al.: Chronic kidney dysfunction can increase the risk of deep vein thrombosis after total hip and knee arthroplasty. Biomed Res Int 2017: 8260487, 2017.

    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 5. 

    Tan TL, Kheir MM & Tan DD et al.: Chronic kidney disease linearly predicts outcomes after elective total joint arthroplasty. J Arthroplasty 31 (suppl): 175, 2016.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 6. 

    Schmidt AH, Leighton R & Parvizi J et al.: Optimal arthroplasty for femoral neck fractures: is total hip arthroplasty the answer. J Orthop Trauma 23: 428, 2009.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 7. 

    Zhang YL, Chen S & Ai ZS et al.: Osteonecrosis of the femoral head, nonunion and potential risk factors in Pauwels grade-3 femoral neck fractures: a retrospective cohort study. Medicine (Baltimore) 95: e3706, 2016.

    • Crossref
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 8. 

    Wang C, Xu GJ & Han Z et al.: Correlation between residual displacement and osteonecrosis of the femoral head following cannulated screw fixation of femoral neck fractures. Medicine (Baltimore) 94: e2139, 2015.

    • Crossref
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 9. 

    Zuo WM, Yang L & Wang JJet al:. Middle-and short-term follow-up of biological artificial femoral head replacement in elderly patients with proximal femoral fracture of chronic renal disease. Chin J Tissue Eng Res 15: 2315, 2018.

    • Search Google Scholar
    • Export Citation
  • 10. 

    Engh CA, McAuley JP & Sychterz CJ et al.: The accuracy and reproducibility of radiographic assessment of stress-shielding. A postmortem analysis. J Bone Joint Surg Am 82: 1414, 2000.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11. 

    Dorr LD, Absatz M & Gruen TA et al.: Anatomic porous replacement hip arthroplasty: first 100 consecutive cases. Semin Arthroplasty 1: 77, 1990.

  • 12. 

    Howell SJ, Sear YM & Yeates Det al. Risk factors for cardiovascular death after elective surgery under general anaesthesia. Br J Anaesth 80: 14, 1998.

  • 13. 

    Wattanakit K, Cushman M & Stehman-Breen C et al.: Chronic kidney disease increases risk for venous thromboembolism. J Am Soc Nephrol 19: 135, 2008.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 14. 

    Gruen TA, McNeice GM & Amstutz HC: “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res 141: 17, 1979.

    • Search Google Scholar
    • Export Citation
  • 15. 

    Nagoya S, Nagao M & Takada J et al.: Efficacy of cementless total hip arthroplasty in patients on long-term hemodialysis. J Arthroplasty 20: 66, 2005.

  • 16. 

    Li WC, Shih CH & Ueng SW et al.: Uncemented total hip arthroplasty in chronic hemodialysis patients. Acta Orthop 81: 178, 2010.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 17. 

    Rogmark C, Fenstad AM & Leonardsson O et al.: Posterior approach and uncemented stems increases the risk of reoperation after hemiarthroplasties in elderly hip fracture patients. Acta Orthop 85: 18, 2014.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 18. 

    Sunday JM, Guille JT & Torg JS: Complications of joint arthroplasty in patients with end-stage renal disease on hemodialysis. Clin Orthop Relat Res 397: 350, 2002.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19. 

    Koebnick C, Langer-Gould AM & Gould MK et al.: Sociodemographic characteristics of members of a large, integrated health care system: comparison with US Census Bureau data. Perm J 16: 37, 2012.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20. 

    McCleery MA, Leach WJ & Norwood T: Rates of infection and revision in patients with renal disease undergoing total knee replacement in Scotland. J Bone Joint Surg Br 92: 1535, 2012.

    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 21. 

    Wang TI, Hung SH & Su YP et al.: Noncemented total hip arthroplasty for osteonecrosis of the femoral head in elderly patients. Orthopedics 36: e271, 2013.

    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 22. 

    Bozic KJ, Lau E & Kurtz S et al.: Patient-related risk factors for postoperative mortality and periprosthetic joint infection in medicare patients undergoing TKA. Clin Orthop 470: 130, 2012.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 23. 

    Bozic KJ, Lau E & Kurtz S et al.: Patient related risk factors for periprosthetic joint infection and postoperative mortality following total hip arthroplasty in Medicare patients. J Bone Joint Surg Am 94: 794, 2012.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 24. 

    Lejus C, Desdoits A & Lambert C et al.: Preoperative moderate renal impairment is an independent risk factor of transfusion in elderly patients undergoing hip fracture surgery and receiving low-molecular-weight heparin for thromboprophylaxis. J Clin Anesth 24: 378, 2012.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 25. 

    Sonaje JC, Meena PK & Bansiwal RC et al.: Comparison of functional outcome of bipolar hip arthroplasty and total hip replacement in displaced femoral neck fractures in elderly in a developing country: a 2-year prospective study. Eur J Orthop Surg Traumatol 28: 493, 2018.

    • Crossref
    • Search Google Scholar
    • Export Citation

Can Total Joint Arthroplasty Be Safely Performed in Patients with Chronic Kidney Disease?

Kai Sun MD, Meng Fan PhD, and Wenxue Jaing PhD
View More View Less
Restricted access

Background

Patients suffering from chronic kidney disease are at greater risk of perioperative and postoperative complications. There is no systematic review study demonstrating whether total joint arthroplasty can be safely performed in patients with chronic kidney disease.

Methods

A literature search was performed in the PubMed, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, and Cochrane Library databases for information from the earliest date of data collection to September of 2018. Studies comparing the perioperative and postoperative outcomes of no–chronic kidney dysfunction (CKD) patients with those of CKD patients were included. Statistical heterogeneity was quantitatively evaluated by means of the χ2 test, with significance set at P < .10 or I 2 > 50%.

Results

Three articles consisting of 38,209 patients were included (35,363 no-CKD patients and 2,846 CKD patients). The results showed that CKD was related to a greater increase in postoperative infection rate, deep vein thrombosis, readmission, and mortality (P < .1). No differences in length of surgery, length of stay, pulmonary embolism, or revision were observed (P > .10).

Conclusions

Compared with no-CKD patients, CKD patients demonstrated an increased risk of perioperative and postoperative complications.

Tianjin First Center Hospital, Tianjin, People's Republic of China.

Corresponding author: Kai Sun, MD, Tianjin First Center Hospital, Fukang Rd #24, Nankai District, Tianjin 300192, People's Republic of China. (E-mail: sunkaiortholivea@sina.cn)

Conflict of Interest: None reported.