Revision total knee arthroplasty outcomes in solid organ transplant Patients, a matched cohort study of aseptic and infected revisions

Background: Previous studies have demonstrated that solid organ transplant (SOT) patients undergoing primary total knee arthroplasty (TKA) are at an increased risk of postoperative complications. The purpose of this study is to utilize a large, national database to investigate revision TKA (rTKA) outcomes in SOT patients. Methods: This was a retrospective review utilizing the Nationwide Readmissions Database (NRD) and ICD-9 codes to identify patients who underwent rTKA from 2010-2014 with a history of at least one SOT. Propensity-score-matching (PSM) was used to compare rTKA outcomes in SOT patients compared to matched patients without SOT. Results: A total of 303,867 rTKAs, with 464 of those being performed in SOT patients, were included in the study. Of these, 71,903 and 182 were performed for PJI in non-SOT and SOT patients, respectively. rTKA was performed most frequently in kidney transplant patients (53.0%) followed by liver transplant patients (34.3%). For non-PJI patients, SOT patients had a higher 90-day readmission rate than matched non-SOT rTKA patients (23.2% vs 12.6%, p = 0.006). However, there were no differences in 90-day readmission rates for specific rTKA complications, subsequent revision rTKA, or mortality. Among patients undergoing rTKA for PJI, there was no difference in overall 90-day readmission rate, readmission for specific rTKA complications, subsequent revision rTKA, or mortality. Conclusions: While the increased medical comorbidities associated with SOT place patients at increased risk for complications following rTKA, it appears that SOT alone does not do so when patients are matched based on overall medical comorbidity

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Editor's Introduction

Assessments of Russia's future have become something of a cottage industry in recent years. The confluence of a new millennium with the failure of market-oriented reform to move in its anticipated direction have raised legitimate questions as to what we can reasonably expect of this society in the next century. The contributions to this issue of >i>Problems of Economic Transition>/i> reflect critical views of Russia's weaknesses, as well as a surprisingly high level of agreement about the need for a more effective and active role of the state in economy and society. Clearly, the central article is Iuri Luzhkov's piece pondering Russia's prospects for prosperity. The arguments that the mayor of Moscow presentsâon the need for a more gradualist approach to reform and the focus on a rather nebulously defined "philosophy of prosperity"âare not new. Their importance lies, however, in the fact that Luzhkov is a clear contender to succeed President Boris Yeltsin in the year 2000. Hence, his article provides us with a glimpse of what a Luzhkov presidency would mean for Russian politics and society, as well as for the Western world.

Editor's Introduction

The Russian banking crisis is perhaps the most prominent manifestation associated with the August 1998 financial crisis. In a remarkably short period of time, what seemed the most promising sector in terms of economic growth was transformed into a financial black hole. Russias banks, essential for the accumulation of financial operations required to fund the economic revival of a major country, were now little more than a series of cash registers in which money simply changed handsinvestment and the production of value had all but disappeared. Even more disturbing was Russias subsequent inability to take concerted action to surmount the crisis. Restructuring the banking industry was called for, yet the Russian government and the Central Bank of Russia (CBR) were enmeshed in politiqal considerations: struggles between elite factions and the pressure from once mighty oligarchs contaminated efforts to build a stable post-crisis banking system.

Editor's Introduction

If there is a single theme that runs through the contributions to the current issue of >i>Problems of Economic Transition (PET),>/i> it is that the Russian state will come to play a greater role in the management of the economy than has been the case in the preceding decade of reform. All of the authors agree that some form of industrial policy is a necessity for Russian economic development, as is the strengthening of the state's capacity for revenue collection. An equally important theme emerges in the sense of urgency that has pervaded the Russian context, punctuated by considerable anxiety over the (then) Primakov government's slowness in addressing core issues. Of course, none of the authors can be held accountable for failing to anticipate the erratic gestures of Boris Yeltsin, but the subsequent removal of Primakov and then Sergei Stepashin have doubtless heightened the concerns raised here that political struggles in the Kremlin have postponed the honest facing of critical issues.