Youngman Tyler R, Riepen Dietrich W, Rinehart Dustin B, Thota Dharani Rohit, Sun Joshua J, Telford Clara L, Huo Michael H
Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Baylor Scott & White, Dallas, TX, USA.
Hip Int. 2023 Jan;33(1):62-66. doi: 10.1177/11207000211005750. Epub 2021 Apr 8.
Femoral head osteonecrosis (FHON) is a well-recognised complication in patients with human immunodeficiency virus (HIV) infection. Total hip arthroplasty (THA) is a reliable solution to FHON and has provided functional improvement and pain relief in these patients. Higher complication rates, in particular infections, have been reported in the series of THAs done in the HIV-positive patients. The purpose of this study was to evaluate the complication rate of THA for FHON in HIV-positive patients managed with the highly active antiretroviral therapy (HAART) protocols.
A retrospective review was performed of HIV-positive patients with FHON who underwent THAs over a 10-year period at a single institution.
A total of 56 THAs (44 patients) met the inclusion criteria. The mean age at the time of THAs was 47 (range 34-60) years. Of the 44 patients, 39 (88.6%) were males. The mean follow-up was 6.6 (range 2.0-11.3) years. The overall complication rate was 12.5%, with 2 (3.6%) cases of deep periprosthetic infections.
HIV-positive patients with FHON undergoing THAs do have a considerable complication rate (12.5%). The deep periprosthetic infection rate (3.6%) in these patients, however, has decreased with contemporary disease modification protocols.
股骨头坏死（FHON）是人类免疫缺陷病毒（HIV）感染患者中一种公认的并发症。全髋关节置换术（THA）是治疗FHON的可靠方法，已为这些患者带来了功能改善和疼痛缓解。在HIV阳性患者中进行的一系列THA手术中，已报告了较高的并发症发生率，尤其是感染。本研究的目的是评估在采用高效抗逆转录病毒疗法（HAART）方案治疗的HIV阳性患者中，THA治疗FHON的并发症发生率。
对在单一机构接受THA手术的FHON HIV阳性患者进行了为期10年的回顾性研究。
共有56例THA手术（44例患者）符合纳入标准。THA手术时的平均年龄为47岁（范围34 - 60岁）。44例患者中，39例（88.6%）为男性。平均随访时间为6.6年（范围2.0 - 11.3年）。总体并发症发生率为12.5%，其中2例（3.6%）发生深部假体周围感染。
接受THA手术的FHON HIV阳性患者确实有相当高的并发症发生率（12.5%）。然而，随着当代疾病改善方案的实施，这些患者的深部假体周围感染率（3.6%）有所下降。
