Does HIV Infection Increase the Risk of Perioperative Complications After THA? A Nationwide Database Study

Abstract

Background Recent studies have shown successful mid-

CORR Insights®: No Decrease in Knee Survivorship or Outcomes Scores for Patients With HIV Infection Who Undergo TKA

“…Among patients with well-managed HIV and no concurrent diagnosis of hemophilia, the authors of the current study found no decrease in survivorship or increase in complications at a mean followup of 6 years. This is in contrast to a number of earlier studies [4,5,7,9] examining joint arthroplasty in patients with HIV, which suggested a greater risk of complications and poorer implant survival in this patient group.…”

Coronary revascularization for acute myocardial infarction in the HIV population

“…We suspect that factors inherent to their HIV‐status, like risk of infections and medications used, along perhaps with social factors could contribute to these findings. Increased LOS has been noted previously following other procedures in HIV‐infected individuals . However, a recent analysis by Robich et al using data from the NIS dataset found no differences in LOS or hospitalization cost following cardiac surgery in HIV‐infected individuals when compared to non‐infected individuals …”

No Decrease in Knee Survivorship or Outcomes Scores for Patients With HIV Infection Who Undergo TKA

“…1 A Kaplan-Meier survivorship curve for the HIV (red) and control (blue) cohorts up to 10 years is shown when considering TKA. Some studies have suggested that patients with HIV may have a higher risk of complications after undergoing a TKA [11,12] and less satisfactory implant survival [11,15,17], however, a recent database study showed no significant differences in overall perioperative complications [5]. Therefore, we aimed to determine if patients with HIV had comparable clinical outcomes and complication rates as matched counterparts.…”

“…However, there is great concern that these patients may be at greater risk when they undergo any elective surgical procedures, including lower extremity total joint arthroplasty [12,14]. Numerous studies have reported a higher risk of perioperative complications including myocardial infarction, acute renal failure, and surgical site infection [6,[11][12][13]15]. Furthermore, some studies have reported lower implant survivorship after total joint arthroplasty in patients with HIV compared with those without the virus [17,21].…”

“…In our practices, we observed that patients with HIV were experiencing similar clinical outcomes compared with other patients. However, we thought that careful analysis needed to be done, given the disagreement among published studies on this population [11,15,17]. Furthermore, there is a paucity of comparative studies regarding the outcomes after TKA in patients with HIV at mid-term followup.…”