End-stage renal disease patients have comparable results to renal transplant patients after shoulder arthroplasty

Daniel Chiou, MD; Kevin Chen, BA; Seth Ahlquist, MD; Peter Hsiue, MD; Alexandra Stavrakis, MD; Christos Demetris Photopoulos, MD

JSES International (Nov 2023)

End-stage renal disease patients have comparable results to renal transplant patients after shoulder arthroplasty

Daniel Chiou, MD,
Kevin Chen, BA,
Seth Ahlquist, MD,
Peter Hsiue, MD,
Alexandra Stavrakis, MD,
Christos Demetris Photopoulos, MD

Affiliations

Daniel Chiou, MD: Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA, USA; Corresponding author: Daniel Chiou, MD, Department of Orthopaedic Surgery, Sports Medicine, University of California at Los Angeles Health System, 100 Medical Plaza Driveway, Suite 170, Los Angeles, CA 90095, USA.
Kevin Chen, BA: Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA, USA
Seth Ahlquist, MD: Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA, USA
Peter Hsiue, MD: Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA, USA
Alexandra Stavrakis, MD: Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA, USA
Christos Demetris Photopoulos, MD: Kerlan-Jobe Orthopaedic Institute, Los Angeles, CA, USA

Journal volume & issue: Vol. 7, no. 6
pp. 2420 – 2424

Abstract

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Background: End-stage renal disease (ESRD) and renal transplant (RT) patients are known to have more perioperative and postoperative complications after arthroplasty surgeries when compared to patients without. We hypothesize that RT patients undergoing shoulder arthroplasty (SA) have fewer systemic and surgical complications when compared to ESRD patients undergoing SA. Methods: This was a retrospective review from the PearlDiver Patient Record Database. International Classification of Diseases and Current Procedural Terminology codes were used to identify patients who had undergone primary total and reverse shoulder arthroplasty, respectively, and subsequent surgical revisions. Unadjusted univariate analysis of patient demographics, Charlson Cormorbidty Index, and surgical complications at 90 days, 1 year, and 2 years after was performed using chi-squared testing. Multivariate logistic regression analyses were subsequently performed for systemic complications and prosthesis outcomes at all time points. Results: Of 1191 patients with ESRD or previous RT and who underwent either total shoulder arthroplasty or reverse total shoulder arthroplasty, 1042 (87.5%) had ESRD and 149 (12.5%) had a previous RT. ESRD SA patients were more likely to have hypertension, liver disease, coronary artery disease, and hypothyroidism. Interestingly no statistical significance was found in multivariate analysis for systemic complications at 90 days, nor for surgical complications at the 90-day, 1-year, or 2-year mark between ESRD and RT cohorts. Conclusion: SAs have comparable outcomes in ESRD and RT patients. The differing conclusions among studies might be partially accounted for by the demographic differences and comorbidities between these 2 patient populations. Providers should continue to provide appropriate counseling concerning risks, benefits, and timing of SA for these patients.

Published in JSES International

ISSN: 2666-6383 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery: Orthopedic surgery; Medicine: Internal medicine: Specialties of internal medicine: Diseases of the musculoskeletal system
Website: https://www.journals.elsevier.com/jses-international

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