Human Immunodeficiency Virus Infection and Hip and Knee Arthroplasty

Dimitriou, Dimitrios; Ramokgopa, Mmampapatla Thomas; Pietrzak, J; Jagt, Dick van der; Mokete, Lipalo

doi:10.2106/jbjs.rvw.17.00029

Cited by 33 publications

(35 citation statements)

References 46 publications

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“…In summary, despite our current optimization protocols, HIVþ TKA recipients were at slightly increased risk for infection and other postoperative complications as compared with an HIVÀ cohort. [36][37][38]45 However, the rate of PJI in the current study is less than other studies examining TJA in HIVþ individuals. 38 Future lines of inquiry should look at the importance of comorbidities, age, length of HIV infection, viral load, and CD4þ T cell count to see how these risk factors correlate with outcomes.…”

Section: Discussioncontrasting

confidence: 61%

“…[36][37][38]45 However, the rate of PJI in the current study is less than other studies examining TJA in HIVþ individuals. 38 Future lines of inquiry should look at the importance of comorbidities, age, length of HIV infection, viral load, and CD4þ T cell count to see how these risk factors correlate with outcomes. Although their risk may be slightly elevated, each HIVþ patient should be evaluated as an individual with specific medical histories to properly optimize them for successful outcomes following TKA.…”

Section: Discussioncontrasting

confidence: 61%

“…One HIVþ patient developed periprosthetic joint infection within the 90 days following TKA, resulting in an infection rate that is elevated as compared with historic norms in the general population undergoing TKA. [36][37][38] Interestingly, the overall infection rate in the current study was less than that found in a systematic review conducted by Dimitriou et al 38 on HIVþ patients undergoing TJA. They found an infection rate of 7.6% in HIVþ patients as compared with 3.3% in controls.…”

Section: Infection Ratescontrasting

confidence: 64%

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Outcomes of Total Knee Arthroplasty in Human Immunodeficiency Virus-Positive Patients

et al. 2019

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AbstractSuccessful management of human immunodeficiency virus (HIV) has lengthened the life expectancy of HIV-positive (HIV + ) patients; consequently, increasing numbers of this patient population are candidates for total knee arthroplasty (TKA). This study seeks to provide detailed results of TKA in HIV+ patients and compare them to an HIV-negative (HIV − ) cohort. We performed a multicenter retrospective case–control study comparing 25 HIV+ patients to 25 HIV− patients undergoing TKA. The analysis included a cohort and subgroup stratification based on the presence or absence of postoperative complications. Prior to TKA, all 25 patients had a documented history of HIV infection. No intraoperative complications were reported. Ninety-day postoperative complications included knee contracture (one HIV + , no HIV − , p = 0.3124), periprosthetic joint infection requiring revision (one HIV + , no HIV − , p = 0.3124), mechanical fall requiring incision and drainage (one HIV + , no HIV − , p = 0.3124), and death (one HIV + , no HIV − , p = 0.3124). The average follow-up was 18.80 months. HIV+ patients stayed in the hospital for an average of 3.8 days following surgery, which was significantly greater than HIV− patients (2.28 days; p = 0.0040). As the life expectancy for HIV+ patients improves, a greater number will be TKA candidates. This study has shown an acceptable postoperative complication risk in an HIV+ patient population undergoing TKA, albeit with a significantly increased hospital length of stay.

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Section: Discussioncontrasting

confidence: 61%

Section: Discussioncontrasting

confidence: 61%

Section: Infection Ratescontrasting

confidence: 64%

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Outcomes of Total Knee Arthroplasty in Human Immunodeficiency Virus-Positive Patients

et al. 2019

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“…D. Dimitriou c соавторами, проведя систематический обзор публикаций, выявили, что риск перипротезной инфекции у ВИч-инфицированных пациентов после артропластики крупных суставов в среднем составлял 7,6%, а у пациентов контрольных групп -3,3% [18]. По данным B.M.…”

Section: Discussionunclassified

“…Проведя обзор 21 клинической статьи, D. Dimitriou с соавторами сделали вывод, что повышение вирусной нагрузки является более чувствительным предиктором инфекционных осложнений, чем снижение CD4-лимфоцитов [18]. напротив, G.N.…”

Section: Discussionunclassified

Treatment Outcomes of Periprosthetic Joint Infection in HIV-positive Patients

Tryapichnikov

Triapichnikov²,

Ермаков

et al. 2019

Traumatology and Orthopedics of Russia

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Relevance. There is a limited number of publications reporting outcomes of primary large joint arthroplasty in patients with human immunodeficiency virus (HIV). The authors were unable to find papers on revision arthroplasty in patients with periprosthetic infection. Purpose of the study — to evaluate short term outcomes after revision arthroplasty in HIV-positive patients with periprosthetic infection of the hip and knee joint. Materials and methods. 13 HIV-positive patients with periprosthetic infection of the hip (10 cases) and knee (3 cases) joint underwent treatment in the period from 2015 to 2019. Patients were examined by clinical, laboratory and roentgenological methods. Harris Hip Score and Knee Society Score were used for evaluation prior to and after the surgery. Results. Mean follow up period was 21,4±2,6 months. Successful two-stage treatment was performed in two (15,4%) out of 13 patients with periprosthetic infection. In 5 cases (38,5%) control over infection was achieved by resection arthroplasty, and in one case (7,7%) – by arthrodesis. Five patients (38,5%) refused from interchange of spacer to prosthesis. Mean Harris Hip score demonstrated insignificant increase postoperatively — from 45,3±2,2 to 52,2±4,15 (р = 0,2). Conclusion. Despite following the international protocols for treatment of implant-associated infection the infection recurrence rate in HIV-positive patients in the asymptomatic phase remains very high. Efficiency of twostage treatment using antibacterial spacers in the present group of patients amounted only to 15,4%.

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