Evidence mapPaperPMID 41197662Full record

SynthesisBone & joint open2025

Impact of liver cirrhosis on postoperative outcomes following total hip and knee arthroplasty : a systematic review and meta-analysis.

Amir-Mohammad Asgari, Farhad Shaker, Mahda Malekshahi, Kiarash Tavakoli, Farnam Behroo, Mohammad-Taha Pahlevan-Fallahy, Amir Kasaeian

Abstract readSystematic Review
In one paragraph

Synthesis in Bone & joint open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Amir-Mohammad AsgariSchool of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Farhad ShakerSchool of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Mahda MalekshahiSchool of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Kiarash TavakoliTehran Heart Center, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Farnam BehrooSchool of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mohammad-Taha Pahlevan-FallahySchool of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Amir KasaeianResearch Center for Chronic Inflammatory Diseases, Tehran University of Medical Sciences, Tehran, Iran.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Aims: Cirrhosis is a known comorbidity that may influence outcomes following total joint replacement (TJR). This meta-analysis evaluates the impact of cirrhosis on postoperative complications and mortality after TJR. Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. Four databases were searched up to February 2025. Studies comparing the outcomes of TJR in cirrhotic versus non-cirrhotic patients were included. Data were analyzed using a random-effects model, and subgroup and sensitivity analyses were performed. Results: A total of 12 studies, including 12.8 million TJR cases, were analyzed, with 111,011 cirrhotic patients. Cirrhosis was significantly associated with higher rates of mortality (odds ratio (OR) = 4.67, 95% CI 2.58 to 8.43), revision surgery (OR = 2.13, 95% CI 1.60 to 2.83), periprosthetic joint infection (OR = 2.61, 95% CI 2.11 to 3.21), implant failure (OR = 1.86, 95% CI 1.58 to 2.18), prosthetic fracture (OR = 1.89, 95% CI 1.19 to 3.01), transfusion (OR = 1.73, 95% CI 1.56 to 1.92), pneumonia (OR = 1.35, 95% CI 1.17 to 1.56), acute renal failure (OR = 2.16, 95% CI 1.35 to 3.46), readmission (OR = 1.93, 95% CI 1.70 to 2.20), and extended hospital stay (SMD = 0.49, 95% CI 0.28 to 0.69). Gastrointestinal complications (OR = 0.72) and pulmonary thromboembolism (OR = 0.25) were significantly lower. No significant differences were observed for wound complications, bleeding volume, operating time, venous thromboembolism, or cardiac events. Conclusion: Cirrhotic patients undergoing TJR are at greater risk for mortality, complications, and healthcare resource use. These findings underscore the need for multidisciplinary preoperative evaluation and careful risk-benefit assessment to improve outcomes in this vulnerable population.

Identifiers

PMID41197662
PMCPMC12591731

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.