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No Decrease in Knee Survivorship or Outcomes Scores for Patients With HIV Infection Who Undergo TKA
Kimona Issa1, Todd P Pierce1, Steven F Harwin2
1Department of Orthopaedics, School of Health and Medical Sciences, Seton Hall University, South Orange, NJ, USA.
Clinical Orthopaedics and Related Research
|October 16, 2016
Summary
Patients with human immunodeficiency virus (HIV) undergoing total knee arthroplasty (TKA) show comparable outcomes, implant survivorship, and complication rates to those without HIV. Preoperative optimization is key for successful TKA in this population.
Area of Science:
- Orthopedic surgery
- Infectious disease management
- Patient outcomes research
Background:
- Human immunodeficiency virus (HIV) is a global health concern, with patients often requiring total knee arthroplasty (TKA).
- Previous studies suggested higher complication rates for TKA in HIV patients, but these predate modern HIV management.
- It remains unclear if HIV impacts patient-reported outcomes or implant longevity after TKA.
Purpose of the Study:
- To compare TKA outcomes between HIV-positive patients (without hemophilia) and a matched HIV-negative control group.
- To assess differences in patient-reported outcomes, implant survivorship, and complication rates.
- To evaluate the efficacy of contemporary HIV management on TKA results.
Main Methods:
- A cohort of 45 HIV patients (50 TKAs) with minimum 4-year follow-up was compared to 135 matched HIV-negative patients.
- Matching criteria included age, BMI, surgeon, follow-up duration, and diagnosis.
- Outcomes assessed included Knee Society scores, UCLA activity scores, implant survivorship (Kaplan-Meier), and complication rates.
Main Results:
- No significant differences were found in Knee Society objective or functional scores between HIV and control groups.
- University of California, Los Angeles (UCLA) activity scores were also comparable between cohorts.
- Kaplan-Meier analysis revealed no significant difference in implant survivorship (98% vs. 99%) or postoperative complication rates.
Conclusions:
- HIV-positive patients demonstrate similar mid-term clinical outcomes and implant survivorship after TKA compared to HIV-negative individuals.
- Preoperative medical optimization is critical for successful TKA outcomes in patients with HIV.
- Further research with longer follow-up and larger sample sizes is warranted to confirm these findings.
