Login Register Cart 0
Generic placeholder image

Current HIV Research

Editor-in-Chief

ISSN (Print): 1570-162X
ISSN (Online): 1873-4251

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

Outcomes of Revision Arthroplasty for Hip Joint Infection in Matched Groups of HIV-Positive and HIV-Negative Patients

Author(s): Alexander S. Triapichnikov*, Artem M. Ermakov and Tatiana A. Malkova

Volume 20, Issue 5, 2022

Published on: 13 September, 2022

Page: [365 - 372] Pages: 8

DOI: 10.2174/1570162X20666220805093833

Price: $65

Abstract

Background: Several studies reported on periprosthetic infection after primary THA in HIV-positive patients, but very few showed the results of its revision.

Objective: The aim was to compare primary and secondary clinical outcomes after revision arthroplasty for hip joint infection in matched groups of HIV-infected and HIV-negative patients.

Methods: Using the hospital database, thirteen HIV-positive patients (13 infected hips) and thirteen HIV-negative patients of the matched control group (13 infected hips) were identified and their records were studied retrospectively. They underwent revision surgery aimed at infection arrest and total hip replacement due to infection developed after primary THA or infected spacers. Harris Hip Score, reinfection rate, limb shortening, and definite outcomes were evaluated with Wilcoxon, Mann-Whitney, and Chi-squared tests.

Results and Discussion: Spacers with antibiotics were implanted in patients of both groups at the first step of revision, except for one HIV-infected patient who had resection arthroplasty. The mean follow-up was 29.4 ± 2.7 and 33. ± 2.9 months for the HIV-group and control group, respectively. Three patients of the HIV-group completed two-stage revision arthroplasty versus ten patients from the control group. Re-infection rate was higher in the HIV-group. At final follow-ups, the mean HHS was significantly different (53 ± 3.2 points in the HIV-group versus 79.14 ± 3.1 points in the control group) along with limb length discrepancy (3.71 ± 0.43 versus 1.4 ± 0.32).

Conclusion: Both primary and secondary clinical outcomes of revision arthroplasty for hip joint infection in HIV-positive patients were significantly worse than in the matched group of HIVnegative patients. Revisions in HIV-positive group resulted in a higher reinfection rate, a small number of definite two-stage revisions, and lower functional scores.

Keywords: Human Immunodeficiency Virus, hip joint, periprosthetic infection, revision arthroplasty, hip joint.

« Previous Next »
Graphical Abstract

Pietrzak J.R.T.; Maharaj Z.; Mokete L.; Sikhauli N.; Human immunodeficiency virus in total hip arthroplasty. EFORT Open Rev 2020,5(3),164-171 10.1302/2058-5241.5.190030 32296550 Enayatollahi M.A.; Murphy D.; Maltenfort M.G.; Parvizi J.; Human immunodeficiency virus and total joint arthroplasty: The risk for infection is reduced. J Arthroplasty 2016,31(10),2146-2151 10.1016/j.arth.2016.02.058 27131415 Novikov D.; Anoushiravani A.A.; Chen K.K.; Wolfson T.S.; Snir N.; Schwarzkopf R.; Total hip arthroplasty in human immunodeficiency virus-positive patients: A concise follow-up at 10 to 14 years. J Arthroplasty 2019,34(3),522-526 10.1016/j.arth.2018.11.001 30503321 Capogna B.M.; Lovy A.; Blum Y.; Kim S.J.; Felsen U.R.; Geller D.S.; Infection rate following total joint arthroplasty in the HIV population. J Arthroplasty 2013,28(8),1254-1258 10.1016/j.arth.2012.12.021 23523495 Zhao C.S.; Li X.; Zhang Q.; Sun S.; Zhao R.G.; Cai J.; Early outcomes of primary total hip arthroplasty for osteonecrosis of the femoral head in patients with human immunodeficiency virus in China. Chin Med J (Engl) 2015,128(15),2059-2064 10.4103/0366-6999.161364 26228219 Lin C.A.; Takemoto S.; Kandemir U.; Kuo A.C.; Mid-term outcomes in HIV-positive patients after primary total hip or knee arthroplasty. J Arthroplasty 2014,29(2),277-282 10.1016/j.arth.2013.06.015 23867663 Falakassa J.; Diaz A.; Schneiderbauer M.; Outcomes of total joint arthroplasty in HIV patients. Iowa Orthop J 2014,34,102-106 25328467 Lehman C.R.; Ries M.D.; Paiement G.D.; Davidson A.B.; Infection after total joint arthroplasty in patients with human immunodeficiency virus or intravenous drug use. J Arthroplasty 2001,16(3),330-335 10.1054/arth.2001.21454 11307131 Parvizi J.; Sullivan T.A.; Pagnano M.W.; Trousdale R.T.; Bolander M.E.; Total joint arthroplasty in human immunodeficiency virus-positive patients: An alarming rate of early failure. J Arthroplasty 2003,18(3),259-264 10.1054/arth.2003.50094 12728415 Tan T.L.; Maltenfort M.G.; Chen A.F.; Development and evaluation of a preoperative risk calculator for periprosthetic joint infection following total joint arthroplasty. J Bone Joint Surg Am 2018,100(9),777-785 10.2106/JBJS.16.01435 29715226 Boddapati V.; Fu M.C.; Tetreault M.W.; Blevins J.L.; Richardson S.S.; Su E.P.; Short-term complications after revision hip arthroplasty for pros-thetic joint infection are increased relative to noninfectious revisions. J Arthroplasty 2018,33(9),2997-3002 10.1016/j.arth.2018.05.001 29853307 Graham S.M.; Lubega N.; Mkandawire N.; Harrison W.J.; Total hip replacement in HIV-positive patients. Bone Joint J 2014,96-B(4),462-466 10.1302/0301-620X.96B4.33213 24692611 Graham SM; Howard N; Moffat C; Lubega N; Mkandawire N; Harrison WJ; Total hip arthroplasty in a low-income country. JB 10.2106/JBJS.OA.19.00027 Snir N.; Wolfson T.S.; Schwarzkopf R.; Outcomes of total hip arthroplasty in human immunodeficiency virus-positive patients. J Arthroplasty 2014,29(1),157-161 10.1016/j.arth.2013.04.023 23683515 Chalmers B.P.; Abdel M.P.; Taunton M.J.; Trousdale R.T.; Pagnano M.W.; Mid-term results of total hip and total knee arthroplasty in patients with human immunodeficiency virus. Orthopedics 2017,40(4),e699-e702 10.3928/01477447-20170522-03 28558112 Bauer D.E.; Hingsammer A.; Ernstbrunner L.; Total knee arthroplasty in patients with a history of illicit intravenous drug abuse. Int Orthop 2018,42(1),101-107 10.1007/s00264-017-3655-3 29032478 Wieser K.; Zingg P.O.; Betz M.; Neubauer G.; Dora C.; Total hip replacement in patients with history of illicit injecting drug use. Arch Orthop Trauma Surg 2012,132(7),1037-1044 10.1007/s00402-012-1509-4 22476213 Mahure S.A.; Bosco J.A.; Slover J.D.; Vigdorchik J.; Iorio R.; Schwarzkopf R.; Risk of complications after THA increases among patients who are coinfected with HIV and hepatitis. Clin Orthop Relat Res 2018,476(2),356-369 10.1007/s11999.0000000000000025 29529669 Bedair H.S.; Schurko B.M.; Dwyer M.K.; Novikov D.; Anoushiravani A.A.; Schwarzkopf R.; Treatment for chronic hepatitis C prior to total hip arthroplasty significantly reduces periprosthetic joint infection. J Arthroplasty 2019,34(1),132-135 10.1016/j.arth.2018.09.036 30337253 Badano M.N.; Parodi C.; Aloisi N.; Corti M.; Elizalde de Bracco M.M.; Baré P.; Influence of Hepatitis C virus coinfection on immune reconsti-tution in HIV subjects. Med Microbiol Immunol (Berl) 2019,208(6),747-756 10.1007/s00430-019-00619-4 31147782 Swensen S.; Schwarzkopf R.; Total joint arthroplasty in human immunodeficiency virus positive patients. Orthop Surg 2012,4(4),211-215 10.1111/os.12001 23109304 Della Valle C.J.; Paprosky W.G.; The femur in revision total hip arthroplasty evaluation and classification. Clin Orthop Relat Res 2004(420),55-62 10.1097/00003086-200403000-00009 15057079 O’Neill S.C.; Queally J.M.; Hickey A.; Mulhall K.J.; Outcome of total hip and knee arthroplasty in HIV-infected patients: A systematic review. Orthop Rev (Pavia) 2019,11(1),8020 10.4081/or.2019.8020 30996842 Kildow BJ; Politzer CS; DiLallo M; Bolognesi MP; Seyler TM; Short and long-term postoperative complications following total joint arthroplasty in patients with human immunodeficiency virus, hepatitis B, or hepatitis C. J Arthroplasty 2018,33(7S),S86-S92.e1 10.1016/j.arth.2017.10.061 Issa K.; Naziri Q.; Rasquinha V.; Maheshwari A.V.; Delanois R.E.; Mont M.A.; Outcomes of cementless primary THA for osteonecrosis in HIV-infected patients. J Bone Joint Surg Am 2013,95(20),1845-1850 10.2106/JBJS.L.01583 24132358 Dimitriou D.; Ramokgopa M.; Pietrzak J.R.T.; van der Jagt D.; Mokete L.; Human immunodeficiency virus infection and hip and knee arthro-plasty. JBJS Rev 2017,5(9),e8 10.2106/JBJS.RVW.17.00029 28953137 Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV WHOAvailable from: 2015 Clark F.; Gaps remain in Russia’s response to HIV/AIDS. Lancet 2016,388(10047),857-858 10.1016/S0140-6736(16)31480-5 27597456 Jergesen H.E.; Thielen Z.P.; Roever J.A.; Vashon T.T.; Wu H.H.; Yi P.H.; Primary hip and knee arthroplasty in a safety net hospital: Substance abuse and other factors affecting short-term complications. J Arthroplasty 2018,33(9),3003-3008 10.1016/j.arth.2018.05.007 29853309 Habermann B.; Eberhardt C.; Kurth A.A.; Total joint replacement in HIV positive patients. J Infect 2008,57(1),41-46 10.1016/j.jinf.2008.01.045 18336915 d’Ettorre G.; Marchetti F.; Ceccarelli G.; Surgical debridement with muscle flap transposition and systemic teicoplanin therapy for infected hip arthroplasty. Hip Int 2010,20(2),255-257 10.1177/112070001002000218 20544660

Rights & Permissions Print Cite
Article Metrics
3
© 2024 Bentham Science Publishers | Privacy Policy