A Missed Opportunity: The Impact of Hepatitis C Treatment Prior to Total Knee Arthroplasty on Postoperative Complications

The Impact of Hepatitis C on Complication Rates After Revision Total Knee Arthroplasty: A Matched Cohort Study

“…Patients with HCV exhibited a significantly longer mean LOS during the index rTKA, as well as significantly higher rates of 90-day medical complications and joint complications within 2 years postoperatively. These results align with data from prior studies analyzing HCV in primary arthroplasty [ [16] , [17] , [18] , [19] , [20] ]. The increased complication risk in this population is multifactorial and driven by factors such as viral-mediated immune dysfunction and thrombocytopenia [ 20 , 24 ].…”

“…As these patients often have more comorbidities than most patients undergoing an rTKA and higher comorbidity burdens are associated with an increased complication risk [ [41] , [42] , [43] , [44] ], medical optimization before an rTKA is critical in this population. Recent analyses have reported improved outcomes after a primary arthroplasty in patients with HCV who received preoperative antiviral treatment [ 16 , [45] , [46] , [47] ]. It is likely that similar interventions before an rTKA also decrease the complication risk in this population.…”

“…Hepatitis C (HCV) affects more than 3 million Americans and approximately 3.3% of the orthopaedic patient population [ 14 , 15 ]. Prior studies have demonstrated patients with HCV who undergo TKA exhibit higher rates of 90-day medical complications and surgical complications including rTKA than noninfected patients [ [16] , [17] , [18] , [19] , [20] ]. However, the impact of HCV on outcomes of rTKA has not been studied.…”

Does pre-arthroplasty antiviral treatment for hepatitis C reduce complication rates after total shoulder arthroplasty? A matched cohort study

“…HCV has been previously recognized as a risk factor for prosthesis-related complications following elective arthroplasty. 18 Prior research has associated HCV infection with a greater risk of PJI, 11 , 31 mechanical complications, 8 , 38 and revision surgery 23 , 31 after both total knee arthroplasty and total hip arthroplasty. At 1- and 2 years postoperatively, HCV patients in this study exhibited significantly higher rates of revision TSA, PJI, dislocation, and other mechanical complications compared to matched controls.…”

“… 11 , 15 , 18 , 29 Evidences in the lower-extremity arthroplasty literature suggests antiviral treatment before surgery mitigates the risk of postoperative complications conferred by HCV infection, possibly due to the restoration of immune function. 2 , 3 , 27 , 31 …”