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No complications, infection seen in HIV-positive patients after THR

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LIVERPOOL, United Kingdom —Data reported at the British Orthopaedic Association Annual Meeting showed that HIV-positive patients who underwent total hip replacement had significantly improved clinical outcomes at latest follow-up.

“There were no early/late complications or infection in any of the patients. No patients underwent revision surgery and no patients had symptoms or radiolucent signs of loosening,” Simon M. Graham, MBChB, orthopaedic registrar at Royal Liverpool Infirmary in Liverpool, said, here.

Graham reported the mid-term outcomes for 44 HIV-positive patients who underwent total hip replacement in 44 joints. All patients had HIV status confirmed and Harris Hip Scores taken prior to their total hip replacement (THR) surgery performed between January 2005 and May 2015. Most of the patients studied were men and mean patient age was 47 years. The main indication for surgery was osteonecrosis of the femoral head and all patients received a Charnley stem and cemented cup during surgery in a non-laminar flow operating theater.

Graham said he set out to determine the safety of THR in HIV-positive patients who had no history of hemophilia or IV drug use since that type of patient represents the majority of HIV positive adults worldwide today.

The patients were prospectively entered into the Malawi master joint replacement registry and were seen at 6 weeks, 6 months, 1 year, and then yearly. Graham then saw each of the patients on a trip to Malawi in May 2015.

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“I documented postoperative Harris Hip Scores. We also introduced the Oxford Hip Score postoperatively, performed radiographs to test for loosening and also assessed infection or complications,” Graham said.

Overall, the researchers found a statistically significant improvement of 59 points in mean Harris Hip Scores from the preoperative period to the last follow-up. The mean postoperative Oxford Hip Score was 45 points, which he said is good. – by Susan M. Rapp

References:

Graham SM, et al. Paper #14. Presented at: British Orthopaedic Association Annual Congress; Sept. 15-18, 2015; Liverpool, United Kingdom.

Graham SM, et al.See comment in PubMed Commons below Bone Joint J. 2014;doi:10.1302/0301-620X.96B4.33213.

Disclosure: Graham reports no relevant financial disclosures.