Solid Organ Transplant Patients Can Safely Undergo Joint Replacement: Study

Written By : Dr Supreeth D R Published On 2026-08-17T21:00:40+05:30 | Updated On 18 Aug 2026 12:19 PM IST

Solid organ transplant (SOT) patients undergoing total joint arthroplasty (TJA) may be at higher risk for complications due to complex medical and surgical histories, chronic immunosuppressive medications, and significant ongoing comorbidities. Farouk Khury et al conducted a study aimed to evaluate postoperative outcomes following primary, elective TJA in patients with a his-tory of SOT. The article has been published in “European Journal of Orthopaedic Surgery & Traumatology.”

The authors retrospectively reviewed 53,043 primary, elective TJA patients. Patients were screened for SOT history prior to TJA. All SOT patients were taking some form of immunosuppressive medication following their trans-plantation. Demographics, SOT details, and surgical data were obtained. SOT patients (n = 70) underwent a nearest-neighbor 1:3 propensity-score matching to non-SOT (NSOT) controls (n = 210) based on age, sex, smoking, Charlson Comorbidity Index, body-mass index, and TJA indication. Kidney transplants were most common (61.4%), followed by liver (24.3%), and heart (8.6%). Differences in surgical outcomes and postoperative complications between the patients were investigated using Chi-squared tests, independent t-tests and effect size (ES) estimates. Baseline characteristics did not differ between the groups (P > 0.05).

The key findings of the study were:

SOT patients had significantly longer hospital stays (92 vs. 51 h, P < 0.001, ES = 0.82), higher rates of discharge to skilled nursing facilities (SNF) (15.7% vs. 5.7%, P = 0.014, ES = 0.17) and all-cause 90 day readmissions (15.7% vs. 6.7%, P = 0.040, ES = 0.12), primarily driven by non-surgical reasons (14.3% vs. 4.3%, P = 0.010, ES = 0.16) compared to NSOT patients.

All-cause revision rates were comparable between SOT and NSOT patients (4.3% vs. 3.8%, P = 0.999), including aseptic (2.9% vs. 1.9%, P = 0.642) and septic causes (1.4% vs. 1.9%, P = 0.999).

The authors concluded – “Despite higher rates of SNF discharge and non-surgical 90day readmissions, SOT patients achieved similar all-cause, septic, and aseptic revision rates, compared to NSOT patients. These findings suggest that compared to well-matched comorbid controls, SOT patients can safely undergo elective TJA with comparable revision risk. Enhanced perioperative care may help reduce readmission risks in this complex population.”

For further details on the article refer to:

Clinical outcomes of solid organ transplant patients after total joint arthroplasty: a propensity-matched analysis Farouk Khury et al European Journal of Orthopaedic Surgery & Traumatology (2026) 36:203 https://doi.org/10.1007/s00590-026-04740-y

Solid organ transplant arthroplastySOT TJASOT THASOT TKASolid organ transplant joint replacement

Source : European Journal of Orthopaedic Surgery & Traumatology

Dr Supreeth D R

MBBS, Dip. Ortho, DNB ortho, MNAMS

Dr Supreeth D R (MBBS, Dip. Ortho, DNB ortho, MNAMS) is a practicing orthopedician with interest in medical research and publishing articles. He completed MBBS from mysore medical college, dip ortho from Trivandrum medical college and sec. DNB from Manipal Hospital, Bengaluru. He has expirence of 7years in the field of orthopedics. He has presented scientific papers & posters in various state, national and international conferences. His interest in writing articles lead the way to join medical dialogues. He can be contacted at editorial@medicaldialogues.in.

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