Evidence map›Paper›PMID 41284094›Full record

ArticleArchives of orthopaedic and trauma surgery2025

Are patients with active cancer at increased risk of revision surgery after total joint arthroplasty? A propensity-matched study.

Braden V Saba, Olivia Schaffer, Valentina Schiro, Ran Schwarzkopf, Karim Masrouha, Joshua C Rozell

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Article in Archives of orthopaedic and trauma surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

6 authors.

Braden V SabaNew York University Langone Orthopedic Hospital, New York, USA.
Olivia SchafferNew York University Langone Orthopedic Hospital, New York, USA.
Valentina SchiroNew York University Langone Orthopedic Hospital, New York, USA.
Ran SchwarzkopfNew York University Langone Orthopedic Hospital, New York, USA.
Karim MasrouhaNew York University Langone Orthopedic Hospital, New York, USA.
Joshua C RozellNew York University Langone Orthopedic Hospital, New York, USA. joshua.rozell@nyulangone.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionWhile the number of absolute and relative contraindications to total joint arthroplasty (TJA) has gradually decreased, active cancer patients have traditionally been challenging surgical candidates. We sought to compare perioperative and two-year postoperative clinical outcomes of patients with and without active cancer.

methodsPatients over 18 years with active cancer undergoing primary, unilateral TJA from 2017 to 2023 at a single urban academic center were reviewed for a minimum two-year follow-up. Cancer status, type, and stage were confirmed manually. 68 cancer patients were propensity-matched 3:1 to 204 non-cancer patients from a pool of 9,382 based on age, sex, BMI, smoking status, race, and ASA class. Demographic, perioperative, and clinical data were analyzed using t-tests, Chi-square, and ANOVA. Subgroup analyses compared cancer patients receiving active therapy versus those not on treatment.

resultsThere were no significant demographic differences between groups, except Charlson Comorbidity Index (P < 0.001). The most common cancers were breast (22%) and prostate (20%). There were no differences in discharge disposition (P = 0.20), operative time (P = 0.87), or length of stay (P = 0.29). The all-cause revision rate (including infection) was higher in patients with active cancer (7.4% vs. 2.5%), though not statistically significant (P = 0.15; Power = 46.5%). Of the various causes for revision, infection was significantly more likely in cancer patients than other causes compared (4.4% vs. 0%, P = 0.003). When analyzing only the active cancer group, those receiving cancer therapy had higher revision rates, though this was not statistically significant (11.1% vs. 6.0%, P = 0.487). DISCUSSION/

conclusionDespite often being excluded from arthroplasty studies, active cancer patients demonstrated comparable overall outcomes after primary TJA. Although infection-related revisions were more common, they were effectively treated. With proper preoperative optimization and multidisciplinary care, TJA can be safely performed in selected active cancer patients.

Indexed as

Arthroplasty, ReplacementNeoplasmsPostoperative ComplicationsReoperationAgedAged, 80 and overFemaleHumansMaleMiddle AgedPropensity ScoreRetrospective StudiesRisk FactorsCancerChemotherapyClinical outcomesOncologyPeriprosthetic joint infectionTotal joint arthroplasty

Identifiers

PMID41284094

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