Mahoney Craig R, Glesby Marshall J, DiCarlo Edward F, Peterson Margaret G E, Bostrom Mathias P
Iowa Orthopedic Center, 411 Laurel St. #3300, Des Moines, IA 50314, USA.
Acta Orthop. 2005 Apr;76(2):198-203. doi: 10.1080/00016470510030571.
An increased incidence of osteonecrosis of the femoral head has been reported in patients infected with human immunodeficiency virus (HIV). The purpose of this study was to review the pathologic specimens of HIV-positive patients who had undergone total hip arthroplasty (THA) and compare them with those of THA patients who were HIV-negative. The surgical outcomes of these HIV-positive patients were also reviewed.
40 HIV-positive patients who underwent 54 THAs at our institution were identified. The primary pathologic diagnosis for the femoral heads of these patients was osteonecrosis in 35 cases, degenerative joint disease in 11 cases, and other diagnoses in 8 cases.
There was a higher incidence of osteonecrosis in HIV-positive patients. At the most recent follow-up, 4 patients had died and 1 patient had a significant Staphylococcus aureus infection of the hip.
There was a significant difference in the pathologic diagnoses of the HIV-positive group and the HIV-negative group, implicating HIV infection as a risk factor for osteonecrosis. Also, the risk of infectious complications is lower in our study than previously reported in other studies of HIV-positive patients who have undergone THA.
据报道，感染人类免疫缺陷病毒（HIV）的患者中股骨头坏死的发病率有所增加。本研究的目的是回顾接受全髋关节置换术（THA）的HIV阳性患者的病理标本，并将其与HIV阴性的THA患者的标本进行比较。还回顾了这些HIV阳性患者的手术结果。
确定了在我们机构接受54次THA的40例HIV阳性患者。这些患者股骨头的主要病理诊断为骨坏死35例，退行性关节病11例，其他诊断8例。
HIV阳性患者骨坏死的发病率较高。在最近的随访中，4例患者死亡，1例患者发生严重的金黄色葡萄球菌髋关节感染。
HIV阳性组和HIV阴性组的病理诊断存在显著差异，这表明HIV感染是骨坏死的一个危险因素。此外，在我们的研究中，感染性并发症的风险低于先前其他关于接受THA的HIV阳性患者的研究报道。
