Patients with prior solid organ transplant who undergo total joint arthroplasty can expect promising patient-reported outcomes and low mortality at 1-year.

Background: The existing literature has described an increased risk of complications associated with total joint arthroplasty (TJA) in patients who have undergone prior solid organ transplantation (SOT); however, few studies have reported the benefits of TJA in SOT patients as measured by patient-reported outcome measures (PROMs). This study aimed to explore differences in healthcare resource utilization, 1-year patient-reported outcome measures (PROMs), and achievement of minimal clinically important differences (MCIDs) and the patient acceptable symptom state (PASS) thresholds after TJA in SOT patients. Methods: Of 29,254 TJAs performed between 2016 and 2021, 33 THA and 32 TKA patients who underwent prior SOT were included. Outcomes included length of stay (LOS), discharge disposition (DD), 90-day readmission, 1-year reoperation, 1-year mortality, and 1-year PROMs: Hip disability and Osteoarthritis Outcome Score (HOOS) -Pain, HOOS-Physical Function Shortform (HOOS-PS), Knee disability and Osteoarthritis Outcome Score (KOOS) -Pain, and KOOS-Physical Function Short Form (KOOS-PS) were analyzed. Results: The 1-year mortality for SOT patients was 3.0 % and 6.3 % after THA and TKA, respectively. After THA, intestine and kidney transplant patients displayed higher readmission rates, but there were no significant differences in LOS, DD, 1-year reoperation, or 1-year PROMs between SOT patients. One lung transplant patient failed to achieve MCIDs for HOOS-Pain and HOOS-PS. Similarly, one kidney transplant patient was unable to achieve the PASS threshold one year after THA. For TKA patients, there were no significant differences in healthcare resource utilization, PROMs, or PASS achievement between SOT patients. One lung transplant and one liver transplant patient failed to achieve the KOOS-Pain MCID, and one liver transplant patient was unable to achieve the KOOS-PS MCID. Conclusion: At one year, SOT patients who undergo TJA demonstrated favorable PROMs, suggesting these patients can expect promising pain and functional outcomes.