Joint replacement in human immunodeficiency virus-infected patients

Area of Science:

• Orthopedic Surgery
• Infectious Disease
• Immunology

Background:

• Human immunodeficiency virus (HIV)-infected patients face increased risks of infections due to immunosuppression.
• Postoperative infection is a significant concern for patients undergoing joint replacement surgery.

Purpose of the Study:

• To evaluate the postoperative infection rates in human immunodeficiency virus (HIV)-positive patients undergoing arthroplastic procedures.
• To assess the safety and efficacy of joint replacement surgeries in HIV-positive individuals.

Main Methods:

• A retrospective review of 10 joint replacement procedures (hip, knee, shoulder) in six HIV-positive patients from June 2000 to January 2009.
• Standard postsurgical antibiotic prophylaxis was administered.
• Vancomycin-impregnated bone cement was used for specific prostheses (knee and shoulder).

Main Results:

• Despite theoretical higher risks, no postoperative infections were observed in the studied HIV-positive patient cohort.
• The average follow-up period was 38.6 months, indicating sustained outcomes.

Conclusions:

• HIV-positive patients can achieve excellent outcomes following various arthroplastic surgeries.
• Improved outcomes are linked to advances in antiviral therapy, increasing lifespan and suitability for elective procedures.
• Arthroplastic surgery should be considered for HIV-positive patients, given the favorable safety profile observed.