Miller Asaf, Hameed Daniel, Dubin Jeremy, Mont Michael A, Patel Deepak V, Bibbo Christopher, Hong Ian S
University of Maryland, College Park, MD.
Rubin Institute for Advanced Orthopedics, LifeBridge Health, Sinai Hospital of Baltimore, Baltimore, MD.
Arthroplast Today. 2024 May 29;27:101382. doi: 10.1016/j.artd.2024.101382. eCollection 2024 Jun.
Total knee arthroplasty (TKA) has become a common surgical intervention for human immunodeficiency virus (HIV)-positive patients who develop osteonecrosis of the knee. This paper summarized existing literature regarding the outcomes of HIV-positive patients undergoing TKA in 4 subsections: (1) complications; (2) survivorship analyses; (3) patient-reported outcomes; and (4) infections.
A review of PubMed was performed, searching for articles focused on HIV-positive patients undergoing TKA. There were 6 reports selected, containing 4765 HIV-positive patients, and data regarding the various domains was tabulated and analyzed. To ensure article quality, a methodology score and level of evidence were determined for selected studies.
Complication rates for HIV-positive patients were low, with a larger study reporting that 7.8% of HIV-positive patients developed a complication in comparison to 8% of HIV-negative patients. Survivorship analyses showed similar results, with a study reporting implant survivorship of 98% for HIV-positive and 99% for HIV-negative patients. There were no differences in patient-reported outcomes; HIV-positive patients improved from baseline with respect to the mean Knee Society objective and mean Knee Society functional scores, and the University of California, Los Angeles self-reported activity levels. The infection rate for HIV-positive patients was low, with a larger database study reporting that 0.6% of HIV-positive patients developed a wound infection in comparison to 0.4% of HIV-negative patients.
A TKA is an effective treatment for HIV-positive patients who develop osteonecrosis of the knee. Results showed similar patient-reported outcomes, implant survivorships, revisions, and complication rates when compared to non-HIV patients.
全膝关节置换术（TKA）已成为感染人类免疫缺陷病毒（HIV）且发生膝关节骨坏死患者的常见外科干预手段。本文在4个小节中总结了有关HIV阳性患者接受TKA治疗结果的现有文献：（1）并发症；（2）生存率分析；（3）患者报告的结局；（4）感染情况。
对PubMed进行了检索，查找聚焦于HIV阳性患者接受TKA治疗的文章。共筛选出6篇报告，包含4765例HIV阳性患者，并将有关各个领域的数据制成表格进行分析。为确保文章质量，确定了所选研究的方法学评分和证据水平。
HIV阳性患者的并发症发生率较低，一项规模较大的研究报告称，7.8%的HIV阳性患者出现了并发症，而HIV阴性患者的这一比例为8%。生存率分析显示了类似结果，一项研究报告称，HIV阳性患者的植入物生存率为98%，HIV阴性患者为99%。患者报告的结局没有差异；HIV阳性患者在膝关节协会平均客观评分、膝关节协会平均功能评分以及加利福尼亚大学洛杉矶分校自我报告的活动水平方面较基线均有所改善。HIV阳性患者的感染率较低，一项规模较大的数据库研究报告称，0.6%的HIV阳性患者发生了伤口感染，而HIV阴性患者的这一比例为0.4%。
TKA是治疗发生膝关节骨坏死的HIV阳性患者的有效方法。结果显示，与非HIV患者相比，患者报告的结局、植入物生存率、翻修率和并发症发生率相似。
