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Total joint replacement in HIV positive patients.
Bjoern Habermann1, Christian Eberhardt, Andreas A Kurth
1Department of Orthopaedic Surgery, University Hospital Frankfurt/Main, Marienburgstr. 2, 60528 Frankfurt/Main, Germany. b.habermann@friedrichsheim.de
The Journal of Infection
|March 14, 2008
Summary
Total joint replacement is safe for HIV patients, especially hemophiliacs. However, intravenous drug abuse significantly increases complication risks in these orthopaedic procedures.
Area of Science:
- Orthopaedic Surgery
- Infectious Diseases
- Public Health
Background:
- Improved life expectancy for HIV patients necessitates evaluating orthopaedic treatment outcomes.
- HIV-positive patients present unique considerations for total joint replacement (TJR).
- This study focuses on TJR in HIV-positive individuals, including a significant hemophilic population.
Purpose of the Study:
- To analyze the outcomes of total joint replacement in HIV-positive patients.
- To identify perioperative complications associated with TJR in this population.
- To compare outcomes between HIV-positive patients with hemophilia and those with other risk factors.
Main Methods:
- Retrospective analysis of 55 endoprosthetic procedures (THR, TKR, shoulder) in 41 HIV-positive patients (1988-2000).
- Patient cohort included individuals with hemophilia and intravenous drug abuse.
- Mean follow-up of 81 months with annual assessments using Harris Hip Score or Knee Society Rating System.
Main Results:
- Overall complication rate was 12.7%, including septic and aseptic loosening.
- Intravenous drug abuse was associated with increased early infection rates after TKR and THR.
- No correlation observed between infection rate and CD4+ count.
Conclusions:
- Total joint replacement is a relatively safe procedure for HIV-positive hemophilic patients.
- Intravenous drug abuse is a significant risk factor for postoperative complications in HIV-positive patients undergoing TJR.
- Functional outcomes for THR and TKR in HIV-positive patients are comparable to HIV-negative populations.
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