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Updated: Feb 8, 2026
09:31
Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
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Optimal timing for elective total hip replacement in HIV-positive patients
Chun-Hung Chang1, Shang-Wen Tsai2, Cheng-Fong Chen2
1Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Orthopaedics & Traumatology, Surgery & Research : OTSR
|June 17, 2018
Summary
Optimal timing for total hip replacement in HIV-positive patients involves a CD4 count over 200 cells/mm³ and an undetectable viral load. This approach is associated with improved outcomes and reduced complications in eligible patients.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Immunology
Background:
- Optimal timing for total hip replacement (THR) in HIV-positive patients remains unclear.
- HIV infection can impact surgical outcomes, necessitating specific patient selection criteria.
Purpose of the Study:
- To evaluate the outcomes of total hip replacement in HIV-positive patients.
- To identify preoperative criteria indicative of optimal timing for THR in this population.
Main Methods:
- Retrospective analysis of 25 THRs in 16 HIV-positive patients (2003-2015).
- Exclusion of patients with hemophilia or history of intravenous drug use (IVDU).
- Analysis of preoperative CD4 counts, viral load, and postoperative outcomes.
Main Results:
- No cases of superficial surgical site infections, periprosthetic joint infections, or aseptic loosening were reported.
- Postoperative Harris Hip scores showed significant improvement (p<0.001).
- Mean preoperative CD4 count was 464.1 cells/mm³.
Conclusions:
- Preoperative CD4 counts >200 cells/mm³ and undetectable HIV viral load may signify optimal timing for THR.
- These criteria are associated with favorable surgical outcomes in HIV-positive patients without hemophilia or IVDU history.
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