Infected joint replacements in HIV-positive patients with haemophilia.
Joint replacement in HIV-positive patients remains uncommon, with most experience gained in patients with haemophilia. We analysed retrospectively the outcome of 102 replacement arthroplasties in 73 HIV-positive patients from eight specialist haemophilia centres. Of these, 91 were primary procedures. The mean age of the patients at surgery was 39 years, and the median follow-up was for five years. The overall rate of deep sepsis was 18.7% for primary procedures and 36.3% for revisions. This is a much higher rate of infection than that seen in normal populations. A total of 44% of infections resolved fully after medical and/or surgical treatment. The benefits of arthroplasty in haemophilic patients are well established but the rates of complications are high. As this large study has demonstrated, high rates of infection occur, but survivorship analysis strongly suggests that most patients already diagnosed with HIV infection at the time of surgery should derive many years of symptomatic relief after a successful joint replacement. Careful counselling and education of both patients and healthcare workers before operation are therefore essential.
Duke Scholars
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Related Subject Headings
- Survival Rate
- Retrospective Studies
- Prosthesis-Related Infections
- Orthopedics
- Middle Aged
- Joint Prosthesis
- Humans
- Hemophilia A
- HIV Seropositivity
- Adult
Citation
Published In
DOI
ISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- Survival Rate
- Retrospective Studies
- Prosthesis-Related Infections
- Orthopedics
- Middle Aged
- Joint Prosthesis
- Humans
- Hemophilia A
- HIV Seropositivity
- Adult