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Total Hip Arthroplasty Safe for HIV-Positive Patients

Postoperative variables, including rates of pneumonia, wound dehiscence, surgical site infection, no different in matched analysis

By Elana Gotkine HealthDay Reporter

FRIDAY, July 28, 2023 (HealthDay News) — HIV-positive patients undergoing total hip arthroplasty (THA) do not have an increased risk for complications, according to a study published in the May issue of the Journal of Clinical Orthopaedics and Trauma.

Ashish R. Chowdary, from the University of Texas Southwestern Medical Center in Dallas, and colleagues used a national database to assess postoperative outcomes in HIV patients undergoing THA compared to THA patients without HIV. Of the 367,894 THA patients included in the study, 367,390 and 504 were HIV-negative and HIV-positive, respectively. A cohort of 493 HIV-negative patients was created for a matched analysis using a propensity algorithm.

The researchers found that the HIV cohort had lower mean age, a lower proportion of women, lower incidence of diabetes without complications, and lower incidence of obesity. The HIV cohort had an increased incidence of acute kidney injury, pneumonia, periprosthetic infection, and wound dehiscence in the unmatched analysis, most likely due to inherent demographic variables in the HIV population. In the matched cohort, the HIV-positive cohort had lower rates of blood transfusion. No significant differences were seen between HIV-positive and HIV-negative populations in other postoperative variables, including rates of pneumonia, wound dehiscence, and surgical site infection.

“These are important findings because they can help alleviate worries among the medical community about treating a group of patients who are often overlooked,” coauthor Senthil Sambandam, M.D., also of the University of Texas Southwestern Medical Center, said in a statement. “It’s an important quality-of-life issue for many HIV-positive patients.”

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