Total hip replacements in HIV positive patients: method and preliminary results about 17 hips arthroplasties.

Abstract

SUMMARY

The human immunodeficiency virus infection is endemic in Africa. The introduction of the antiretroviral treatment has changed the prognosis of this disease and increase the life expectancy of the infected patients. Therefore some of this patients may need orthopedic prosthesis indicated for trauma or advanced osteoarthritis. Infection is very common in this group of patients and this risk may be increased with the usage of prosthetic material.

The objectives of this study was to determine the current management of these patients based on the reported literature and to assess the complications in this population compare to the general population.

Material and Methods

We have conducted a prospective chart review                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               of the medical records of all HIV infected patients operated for a total hip arthroplasty in our service at the Central Hospital of Yaoundé. During this period, 62 Total hip replacements were performed.  All patients supposed to undergo this procedure were previously screened in order to obtain their HIV status. The minimum follow-up period after surgery was 3 months. Operated patients were on HAART or they were naive. We noticed any complications.

Results

During the last 08 years, fifteen patients underwent surgery for total hip replacement. We made seventeen hips arthroplasties. Complications rate at short term and mean term was comparable to the non-infected HIV population.

Discussion  

Several factors can promote osteonecrosis of femoral head. Do they influence the complications after surgery in the HIV positive population?

Keys-words: Total hip replacement, H.I.V., Highly active anti-retroviral therapy, avascular necrosis of femoral head.