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Saturday, March 3, 2001

Alarming failure rate for TKA, THA in HIV patients

Recent improvement in the care of patients with Human Immunodeficiency Virus (HIV) has led to a better life expectancy for these patients. With increasing longevity a growing subset of patients with HIV may develop end-stage arthritis and become candidates for joint replacement.

An alarming rate of early failure of total knee and total hip arthroplasty in HIV positive patients was reported by researchers Friday in scientific paper 254

They report on a retrospective review of 20 total joint replacements (11 knees, nine hips) in 15 patients. There were 13 males and 2 females with an average age of 38 years (28-68 years). Patients had contracted the HIV infection through multiple blood transfusions for treatment of hemophilia (10), sexual contact (4), or intravenous drug abuse (1).

The mean follow-up was 6.5 years (2-14). Three patients died within two years of joint arthroplasty, and 3 others were dead at last follow-up.

There were 13 reoperations at an average of 3.5 years. Six joints were revised for deep infection, three joints underwent resection arthroplasty without reimplantation, and two joints were revised for aseptic loosening. One patient, with a grossly loose total hip, died prior to revision surgery. At relatively early follow-up, 12 of 20 total knees and total hips had been revised, removed for deep infection, or were grossly loose.

The researchers are Thomas A. Sullivan, MD; Javad Parvizi, MD, FRCS; Mark W. Pagnano, MD; and Robert T. Trousdale, MD, all of Mayo Clinic, Rochester, Minn.

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2001 Academy News March 3 Index C

Last modified 16/February/2001 by IS