Outcomes of primary total knee arthroplasty in patients with hematopoietic stem cell transplantation

Brian P. Chalmers, Cameron K. Ledford, Kevin I. Perry, Tad M. Mabry, Arlen D. Hanssen, Matthew Abdel

Research output: Contribution to journalArticle

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Abstract

Patients who have undergone hematopoietic stem cell transplantation to treat underlying bone marrow pathology represent a unique and potentially high-risk patient population for total knee arthroplasty (TKA). This study retrospectively reviewed 15 TKA procedures performed on 11 patients with a history of hematopoietic stem cell transplantation. The authors analyzed patient survivorship; clinical outcomes, including complications; and implant survivorship. Mean follow-up was 5 years (range, 2-10 years). Patient survivorship free from mortality was 91% (95% confidence interval, 76%-100%) and 55% (95% confidence interval, 25%-85%) at 2 and 5 years, respectively. Patients who underwent hematopoietic stem cell transplantation for multiple myeloma had a significantly higher 5-year mortality rate (100%) compared with patients who had an underlying diagnosis of non-Hodgkin's lymphoma (0%) (P=.008). Mean Knee Society Score improved to 83 postoperatively (P<.001). Two patients (13%) had postoperative wound healing complications that did not lead to periprosthetic joint infection; however, an additional patient (7%) underwent revision surgery at 5 years for periprosthetic joint infection. Estimated implant survivorship without revision was 80% (95% confidence interval, 60%-100%) at 5 years. Elective primary TKA does not appear to affect survivorship in patients with a history of hematopoietic stem cell transplantation. These patients have modest clinical outcomes, higher complication rates as a result of delayed wound healing, and poorer implant survivorship compared with historical control subjects.

Original languageEnglish (US)
Pages (from-to)e774-e778
JournalOrthopedics
Volume40
Issue number5
DOIs
StatePublished - Sep 1 2017

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Knee Replacement Arthroplasties
Hematopoietic Stem Cell Transplantation
Survival Rate
Confidence Intervals
Wound Healing
Joints
Mortality
Infection
Multiple Myeloma
Reoperation
Non-Hodgkin's Lymphoma
Bone Marrow
Pathology

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Outcomes of primary total knee arthroplasty in patients with hematopoietic stem cell transplantation. / Chalmers, Brian P.; Ledford, Cameron K.; Perry, Kevin I.; Mabry, Tad M.; Hanssen, Arlen D.; Abdel, Matthew.

In: Orthopedics, Vol. 40, No. 5, 01.09.2017, p. e774-e778.

Research output: Contribution to journalArticle

Chalmers, Brian P. ; Ledford, Cameron K. ; Perry, Kevin I. ; Mabry, Tad M. ; Hanssen, Arlen D. ; Abdel, Matthew. / Outcomes of primary total knee arthroplasty in patients with hematopoietic stem cell transplantation. In: Orthopedics. 2017 ; Vol. 40, No. 5. pp. e774-e778.
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