Roof Mackenzie A, Anoushiravani Afshin A, Chen Kevin K, Moses Michael J, Wolfson Theodore, Poultsides Lazaros, Schwarzkopf Ran
Department of Orthopaedic Surgery, NYU Langone Health, New York.
Division of Orthopaedic Surgery, Albany Medical Center, Albany, New York.
J Knee Surg. 2020 Aug;33(8):754-761. doi: 10.1055/s-0039-1684011. Epub 2019 Apr 8.
Successful management of human immunodeficiency virus (HIV) has lengthened the life expectancy of HIV-positive (HIV + ) patients; consequently, increasing numbers of this patient population are candidates for total knee arthroplasty (TKA). This study seeks to provide detailed results of TKA in HIV+ patients and compare them to an HIV-negative (HIV - ) cohort. We performed a multicenter retrospective case-control study comparing 25 HIV+ patients to 25 HIV- patients undergoing TKA. The analysis included a cohort and subgroup stratification based on the presence or absence of postoperative complications. Prior to TKA, all 25 patients had a documented history of HIV infection. No intraoperative complications were reported. Ninety-day postoperative complications included knee contracture (one HIV + , no HIV - , = 0.3124), periprosthetic joint infection requiring revision (one HIV + , no HIV - , = 0.3124), mechanical fall requiring incision and drainage (one HIV + , no HIV - , = 0.3124), and death (one HIV + , no HIV - , = 0.3124). The average follow-up was 18.80 months. HIV+ patients stayed in the hospital for an average of 3.8 days following surgery, which was significantly greater than HIV- patients (2.28 days; = 0.0040). As the life expectancy for HIV+ patients improves, a greater number will be TKA candidates. This study has shown an acceptable postoperative complication risk in an HIV+ patient population undergoing TKA, albeit with a significantly increased hospital length of stay.
成功管理人类免疫缺陷病毒（HIV）延长了HIV阳性（HIV +）患者的预期寿命；因此，越来越多的这类患者成为全膝关节置换术（TKA）的候选者。本研究旨在提供HIV +患者TKA的详细结果，并将其与HIV阴性（HIV -）队列进行比较。我们进行了一项多中心回顾性病例对照研究，比较了25例接受TKA的HIV +患者和25例HIV -患者。分析包括根据术后并发症的有无进行队列和亚组分层。在进行TKA之前，所有25例患者均有HIV感染的记录。未报告术中并发症。术后90天的并发症包括膝关节挛缩（1例HIV +，无HIV -，P = 0.3124）、需要翻修的假体周围关节感染（1例HIV +，无HIV -，P = 0.3124）、需要切开引流的机械性跌倒（1例HIV +，无HIV -，P = 0.3124）和死亡（1例HIV +，无HIV -，P = 0.3124）。平均随访时间为18.80个月。HIV +患者术后平均住院3.8天，显著长于HIV -患者（2.28天；P = 0.0040）。随着HIV +患者预期寿命的提高，将有更多患者成为TKA的候选者。本研究表明，接受TKA的HIV +患者群体术后并发症风险可接受，尽管住院时间显著延长。
