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Does Preoperative Antiviral Treatment for Hepatitis C Decrease Risk of Complications After Total Hip Arthroplasty? A

Austin J Ross1, Bailey J Ross1, Olivia C Lee2

  • 1Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana.

The Journal of Arthroplasty
|March 6, 2022
PubMed
Summary

Hepatitis C virus (HCV) increases complications after hip replacement. Preoperative antiviral treatment significantly lowers these risks, especially for readmission and joint infection.

Keywords:
hepatitis C virushipinfectionoutcomespostoperative complicationstotal hip arthroplastytreatment

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Area of Science:

  • Orthopedic surgery
  • Infectious diseases
  • Hepatology

Background:

  • Hepatitis C virus (HCV) infection is linked to higher complication rates after elective arthroplasty.
  • Understanding these risks is crucial for patient management and surgical outcomes.

Purpose of the Study:

  • To assess the impact of HCV on complications following total hip arthroplasty (THA).
  • To evaluate the effect of pre-THA antiviral treatment in HCV patients on postoperative complications.

Main Methods:

  • Retrospective matched cohort study using an administrative claims database.
  • Matched 6,883 HCV patients with 20,694 controls; 920 treated HCV patients with 3,820 untreated HCV patients.
  • Compared 90-day medical and 2-year joint complication rates using multivariable logistic regression.

Main Results:

  • HCV patients had significantly higher rates of 90-day medical complications versus controls.
  • At 2 years, HCV patients showed increased risk for revision THA, dislocation, mechanical complications, periprostastic fracture, and prosthetic joint infection (PJI).
  • Pre-THA antiviral treatment in HCV patients resulted in comparable joint complication risks to controls and lower readmission/PJI rates versus untreated HCV patients.

Conclusions:

  • HCV significantly elevates medical and joint complication risks post-THA.
  • Preoperative antiviral therapy in HCV patients effectively mitigates these risks, improving outcomes.