Kim Hyeon Jun, Kim Sung Soo, Kim Su Jin, Lee Kyung Ho
Department of Orthopedic Surgery, Dong-A University College of Medicine, Busan, Korea.
Department of Pathology, Dong-A University College of Medicine, Busan, Korea.
Hip Pelvis. 2018 Jun;30(2):115-119. doi: 10.5371/hp.2018.30.2.115. Epub 2018 Jun 4.
The diagnostic criteria for sequential rapidly destructive coxarthrosis remain unclear and this condition is rarely reported in patients with human immunodeficiency virus (HIV). Here, we report a case of an HIV-infected 73-year old female who experienced hip joint destruction. The patient was diagnosed with HIV in 2012 (at age 68 years) and began continuous treatment with nucleoside reverse transcriptase and protease inhibitors. Twenty-nine months after her HIV diagnosis, the patient experienced osteonecrosis of the right hip and underwent a total hip arthroplasty (THA). Twelve months post right-hip THA, X-ray results showed good outcomes. Eight months later (20 months post THA), however, osteolysis of the left femoral head was detected upon radiological exam and THA of the left hip was performed; chronic inflammation and fibrosis were identified in the resultant biopsy. Favorable results were obtained at 3 months after the second surgery.
序贯性快速破坏性髋关节病的诊断标准仍不明确，且在人类免疫缺陷病毒（HIV）感染者中鲜有报道。在此，我们报告一例73岁HIV感染女性发生髋关节破坏的病例。该患者于2012年（68岁时）被诊断为HIV感染，并开始接受核苷类逆转录酶和蛋白酶抑制剂的持续治疗。HIV诊断29个月后，患者出现右髋骨坏死并接受了全髋关节置换术（THA）。右髋THA术后12个月，X线检查结果显示预后良好。然而，8个月后（THA术后20个月），放射学检查发现左股骨头骨质溶解，并进行了左髋THA；活检结果显示存在慢性炎症和纤维化。第二次手术后3个月获得了良好的效果。
