ArticleArchives of orthopaedic and trauma surgery2026
Comparing outcomes of total hip arthroplasty between cirrhotic and non-cirrhotic patients through a propensity-matched analysis.
Article in Archives of orthopaedic and trauma surgery, 2026. 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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Abstract
backgroundThe impact of liver cirrhosis on surgical outcomes is well-known. This study aimed to compare postoperative outcomes of total hip arthroplasty (THA) in patients with versus without cirrhosis.
methodsA retrospective review was conducted of all patients who received a THA between 2012 and 2021 with a minimum of two years of clinical follow-up at a single, urban tertiary health center with lab results available to calculate Model for End-stage Liver Disease (MELD) scores. Using demographic variables, patients with and without cirrhosis underwent a 10:1 propensity score match. Short-term clinical outcomes were compared between cohorts. Cirrhotic patients were stratified based on their MELD score as mild (MELD < 10, n = 39) or moderate-to-severe (MELD ≥ 10, n = 10).
resultsOf the 539 patients included in this study, 49 patients were in the cirrhotic group and 490 patients were in the non-cirrhotic group. Compared to non-cirrhotic and mild cirrhotic, moderate-to-severe cirrhotic THA patients had significantly higher incidence of 30-day (2.9% vs. 2.6% vs. 30.0%, p = 0.011) and 90-day readmissions (5.9% vs. 2.6% vs. 30.0%, p = 0.038) due to periprosthetic joint infection (PJI), and higher incidence of 90-day (3.1% vs. 2.6% vs. 20.0%, p = 0.024) and all-time revisions (1.4% vs. 5.1% vs. 20.0%, p = 0.016) due to PJI. There were no differences in overall 90-day reoperation (p = 0.115) and revision risk (p = 0.202) between non-cirrhotic, mild cirrhotic, and moderate-to-severe cirrhotic THA patients. Freedom from all-cause reoperations/revisions did not differ significantly (p = 0.479) between non-cirrhotic and cirrhotic THA patients at 120 months of follow-up.
conclusionsCirrhotic patients, particularly those categorized as moderate-to-severe, undergoing THA may have higher risk of having a readmission or revision for PJI. However, overall 90-day readmission and revision risk were similar between non-cirrhotic and cirrhotic patients. Future research with larger sample sizes and databases is needed to further risk stratify, optimize and counsel cirrhosis patients surrounding THA.
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