Skip to main content
Journal cover image

Total shoulder arthroplasty in patients with HIV infection: complications, comorbidities, and trends.

Publication ,  Journal Article
Bala, A; Penrose, CT; Visgauss, JD; Seyler, TM; Randell, TR; Bolognesi, MP; Garrigues, GE
Published in: J Shoulder Elbow Surg
December 2016

BACKGROUND: Patients with human immunodeficiency virus (HIV) infection were previously at substantial risk for immunosuppression-related complications. As a result of highly active antiretroviral therapy, HIV-infected patients are living longer and are presenting for elective surgery. Outcomes in HIV-infected patients are well described for hip and knee arthroplasty but not for total shoulder arthroplasty (TSA). The purpose of this study was to examine postoperative complications of TSA in HIV-positive patients. METHODS: We queried the entire 2005 to 2012 Medicare database. Current Procedural Terminology and International Classification of Diseases, Ninth Revision, Clinical Modification codes were used to identify the procedure, demographics, comorbidities, and postoperative complications. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. RESULTS: The query returned 2528 HIV-positive patients who underwent TSA or reverse TSA (RTSA). There was increased utilization of TSA and RTSA in this population from 2005 to 2012; 1353 patients had 2-year follow-up. These patients were slightly older and had higher prevalence of comorbidities, suggesting a sicker cohort. HIV-positive patients had alarmingly higher rates of 90-day cerebrovascular accident (OR, 35.98; CI, 30.34-42.67). HIV-positive patients had higher overall rates of broken prosthetic joints (OR, 1.72; CI, 1.20-2.47), periprosthetic infection (OR, 1.36; CI, 1.01-1.82), and TSA revision or repair (OR, 2.44; CI, 1.81-3.28). CONCLUSIONS: To our knowledge, this is the first study that directly examines the postoperative outcomes of HIV-positive patients after TSA or RTSA. As more of these patients present for surgery, surgeons should be aware that these patients might be at increased risk for certain postoperative surgical and medical complications.

Duke Scholars

Published In

J Shoulder Elbow Surg

DOI

EISSN

1532-6500

Publication Date

December 2016

Volume

25

Issue

12

Start / End Page

1971 / 1979

Location

United States

Related Subject Headings

  • Venous Thrombosis
  • Urinary Tract Infections
  • United States
  • Stroke
  • Shoulder Joint
  • Sepsis
  • Retrospective Studies
  • Reoperation
  • Prosthesis-Related Infections
  • Prosthesis Failure
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Bala, A., Penrose, C. T., Visgauss, J. D., Seyler, T. M., Randell, T. R., Bolognesi, M. P., & Garrigues, G. E. (2016). Total shoulder arthroplasty in patients with HIV infection: complications, comorbidities, and trends. J Shoulder Elbow Surg, 25(12), 1971–1979. https://doi.org/10.1016/j.jse.2016.02.033
Bala, Abiram, Colin T. Penrose, Julia D. Visgauss, Thorsten M. Seyler, Timmothy R. Randell, Michael P. Bolognesi, and Grant E. Garrigues. “Total shoulder arthroplasty in patients with HIV infection: complications, comorbidities, and trends.J Shoulder Elbow Surg 25, no. 12 (December 2016): 1971–79. https://doi.org/10.1016/j.jse.2016.02.033.
Bala A, Penrose CT, Visgauss JD, Seyler TM, Randell TR, Bolognesi MP, et al. Total shoulder arthroplasty in patients with HIV infection: complications, comorbidities, and trends. J Shoulder Elbow Surg. 2016 Dec;25(12):1971–9.
Bala, Abiram, et al. “Total shoulder arthroplasty in patients with HIV infection: complications, comorbidities, and trends.J Shoulder Elbow Surg, vol. 25, no. 12, Dec. 2016, pp. 1971–79. Pubmed, doi:10.1016/j.jse.2016.02.033.
Bala A, Penrose CT, Visgauss JD, Seyler TM, Randell TR, Bolognesi MP, Garrigues GE. Total shoulder arthroplasty in patients with HIV infection: complications, comorbidities, and trends. J Shoulder Elbow Surg. 2016 Dec;25(12):1971–1979.
Journal cover image

Published In

J Shoulder Elbow Surg

DOI

EISSN

1532-6500

Publication Date

December 2016

Volume

25

Issue

12

Start / End Page

1971 / 1979

Location

United States

Related Subject Headings

  • Venous Thrombosis
  • Urinary Tract Infections
  • United States
  • Stroke
  • Shoulder Joint
  • Sepsis
  • Retrospective Studies
  • Reoperation
  • Prosthesis-Related Infections
  • Prosthesis Failure