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Does pre-arthroplasty antiviral treatment for hepatitis C reduce complication rates after total shoulder

Austin J Ross1, Bailey J Ross2, Olivia C Lee1,3

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

JSES International
|November 10, 2022
PubMed

Insights

Hepatitis C virus (HCV) increases complications after total shoulder arthroplasty (TSA). Pre-operative antiviral treatment for HCV may reduce the risk of these serious postoperative complications, improving patient outcomes.

Area of Science:

  • Orthopedic Surgery
  • Infectious Diseases
  • Hepatology

Background:

  • Hepatitis C virus (HCV) infection is linked to heightened risks following arthroplasty procedures.
  • Understanding these risks is crucial for optimizing patient care before joint replacement surgery.

Purpose of the Study:

  • To investigate the impact of Hepatitis C virus (HCV) on complication rates after total shoulder arthroplasty (TSA).
  • To evaluate the effect of pre-arthroplasty antiviral treatment in HCV patients undergoing TSA.

Main Methods:

  • Retrospective matched cohort study utilizing an administrative claims database.
  • 1244 HCV patients were matched with 3732 non-infected controls.
  • Multivariable logistic regression analyzed 90-day medical and 2-year prosthesis-related complications.

Main Results:

  • HCV patients had significantly higher rates of blood transfusion, acute kidney injury, readmission, revision TSA, dislocation, mechanical complications, and prosthetic joint infection.
  • Antiviral-treated HCV patients showed a reduced rate of myocardial infarction and comparable rates for other complications versus controls.
  • Compared to untreated HCV patients, those treated with antivirals had fewer 90-day medical complications and prosthetic joint infections.

Conclusions:

  • Hepatitis C virus (HCV) is associated with significantly increased complication rates after total shoulder arthroplasty (TSA).
  • Pre-operative antiviral treatment for HCV may mitigate the risk of postoperative complications, suggesting a beneficial therapeutic strategy.
Abstract

Keywords:
Antiviral treatmentHepatitis CPostoperative complicationsReverse shoulder arthroplastyTotal joint arthroplastyTotal shoulder arthroplasty

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