Li Kangpeng, Ma Rui, Zhao Rugang, Zhang Qiang
Department of Orthopaedics, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China.
Curr HIV Res. 2024;22(2):136-142. doi: 10.2174/011570162X302889240408033958.
In the post-epidemic era, Acquired Immune Deficiency Syndrome (AIDS) remains one of the most prevalent and detrimental infectious diseases worldwide. The incidence of osteonecrosis of the femoral head (ONFH) in AIDS patients is 100 times higher than that in healthy individuals. Although Total Hip Arthroplasty (THA) is ultimately necessary for most patients, there is still a dearth of evidence regarding its safety and efficacy in Chinese AIDS patients.
The clinical data of 49 patients who met the inclusion and exclusion criteria were retrospectively analyzed. Simultaneously, we categorized patients whose hemoglobin and albumin met a specific threshold as the optimized group and performed group comparisons.
There are statistical differences in Harris score and VAS score pre- and post-operation, with a low overall complication rate. Notably, no disparities were observed between the optimized group and the partial optimized group in terms of overall conditions, laboratory examination indicators, severity of ONFH, surgical outcomes, surgical complications, pain perception or functional limitations. Furthermore, no correlation was found between CD4+ T lymphocytes and hemoglobin levels, albumin levels, white blood cell count, or platelet count.
THA is safe and effective in Chinese AIDS patients with ONFH. However, optimal treatment has limited efficacy in AIDS patients undergoing THA for ONFH. The reconsideration and evaluation of the predictive value of CD4+ T lymphocytes for postoperative complications in joint replacement procedures is warranted.
在疫情后时代，获得性免疫缺陷综合征（艾滋病）仍然是全球最普遍且有害的传染病之一。艾滋病患者股骨头坏死（ONFH）的发病率比健康个体高100倍。尽管全髋关节置换术（THA）对大多数患者来说最终是必要的，但在中国艾滋病患者中，关于其安全性和有效性的证据仍然匮乏。
回顾性分析49例符合纳入和排除标准患者的临床资料。同时，将血红蛋白和白蛋白达到特定阈值的患者归类为优化组并进行组间比较。
术前和术后Harris评分和VAS评分存在统计学差异，总体并发症发生率较低。值得注意的是，优化组和部分优化组在总体状况、实验室检查指标、ONFH严重程度、手术结果、手术并发症、疼痛感知或功能限制方面均未观察到差异。此外，未发现CD4+T淋巴细胞与血红蛋白水平、白蛋白水平、白细胞计数或血小板计数之间存在相关性。
THA在中国艾滋病合并ONFH患者中是安全有效的。然而，优化治疗对因ONFH接受THA的艾滋病患者疗效有限。有必要重新考虑和评估CD4+T淋巴细胞对关节置换手术术后并发症的预测价值。
