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Does the hepatitis C virus affect the outcomes of total joint arthroplasty? A meta-analysis of ten studies

Wuzeng Wei1, Tianshen Liu1, Jie Zhao1

  • 1Department of Joint, Tianjin Hospital, No. 406 Jiefang South Rd, Hexi District, Tianjin, 300211, China.

Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association
|January 29, 2019
PubMed

Insights

Patients with hepatitis C virus (HCV) face higher complication, infection, and revision rates after total joint arthroplasty (TJA). This meta-analysis confirms HCV increases TJA risks and necessitates longer hospital stays.

Area of Science:

  • Orthopedic Surgery
  • Infectious Diseases
  • Hepatology

Background:

  • Hepatitis C virus (HCV) affects 3%-8% of orthopedic patients, many undergoing total joint arthroplasty (TJA).
  • The specific impact of HCV on TJA outcomes remains largely undefined.
  • Understanding these risks is crucial for patient management and surgical planning.

Purpose of the Study:

  • To systematically review and meta-analyze existing literature on the impact of HCV on TJA outcomes.
  • To quantify the risks of complications, infection, and revision in HCV-infected patients undergoing TJA.
  • To assess the effect of HCV on hospital stay duration after TJA.

Main Methods:

  • A comprehensive search of electronic databases (PubMed, Web of Science, CNKI, OVID) was conducted.
  • Two independent researchers extracted data and assessed study quality using Cochrane's guidelines.
  • Pooled Standardized Mean Difference (SMD) and Hazard Ratios (HR) with 95% Confidence Intervals (CI) were calculated for outcome assessment.

Main Results:

  • Six articles comprising ten studies met eligibility criteria for this meta-analysis.
  • HCV patients exhibited significantly higher complication rates (HR=1.55, P=0.01) and revision rates (HR=2.21, P=0.012) after TJA.
  • Infection rates were elevated (HR=1.29) and hospital stays were significantly longer (HR=0.88) in HCV-positive individuals.

Conclusions:

  • This meta-analysis is the first to investigate HCV's impact on TJA.
  • HCV-infected patients demonstrate increased rates of complications, infection, and revision following TJA.
  • HCV is associated with prolonged hospital stays, highlighting the need for careful perioperative management.
Abstract

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