It's quite the balancing act, to say the least.
Total knee arthroplasty (TKA) can save society roughly $19,000 per patient (over the course of a lifetime) --- a significant sum considering the number of such procedures performed annually in the United States (600,000 in 2009, according to the American Academy of Orthopaedic Surgeons). But the surgery also can be costly, particularly when the recipients are organ transplant patients.
A study has found patients with a history of solid organ transplant who underwent TKA experienced increased—with relatively modest clinically significant—length of stays, costs and complications but the procedure itself was safe and effective for this population.
Researchers with the Cleveland Clinic and Case Western Reserve University in Ohio identified 6,104 patients with a history of solid organ transplant who underwent primary TKA and compared them with 5,864,317 non-transplant total knee arthroplasty patients.
Compared with non-transplant patients, investigators found a significantly higher prevalence of hypertension, diabetes, rheumatoid arthritis and drug abuse among patients with a history of solid organ transplantation. However, patients with a history of solid organ transplant had a significantly lower prevalence of obesity, hypothyroidism and chronic pulmonary disease.
The study results show a higher mean overall length of stay, as well as a higher overall unadjusted mean total cost per admission, among transplant plants. Statistically significant differences in infection and the need for a transfusion of blood products were found between the patient groups, showing higher complications of both occurrences in transplant patients.
After propensity score adjustment, researchers found a 0.44-day longer length of stay and a $962 higher cost of admission among transplant patients. According to the data, patients with a history of transplantation also were associated with a 1.43-times higher odds of any complication.