Total hip arthroplasty in patients with human immunodeficiency virus infection: pathologic findings and surgical outcomes.
BACKGROUND
An increased incidence of osteonecrosis of the femoral head has been reported in patients infected with human immunodeficiency virus (HIV). The purpose of this study was to review the pathologic specimens of HIV-positive patients who had undergone total hip arthroplasty (THA) and compare them with those of THA patients who were HIV-negative. The surgical outcomes of these HIV-positive patients were also reviewed.


METHODS
40 HIV-positive patients who underwent 54 THAs at our institution were identified. The primary pathologic diagnosis for the femoral heads of these patients was osteonecrosis in 35 cases, degenerative joint disease in 11 cases, and other diagnoses in 8 cases.


RESULTS
There was a higher incidence of osteonecrosis in HIV-positive patients. At the most recent follow-up, 4 patients had died and 1 patient had a significant Staphylococcus aureus infection of the hip.


CONCLUSIONS
There was a significant difference in the pathologic diagnoses of the HIV-positive group and the HIV-negative group, implicating HIV infection as a risk factor for osteonecrosis. Also, the risk of infectious complications is lower in our study than previously reported in other studies of HIV-positive patients who have undergone THA.
Mahoney
Craig R
CR
Iowa Orthopedic Center, 411 Laurel St. #3300, Des Moines, IA 50314, USA.
Glesby
Marshall J
MJ
DiCarlo
Edward F
EF
Peterson
Margaret G E
MG
Bostrom
Mathias P
MP
D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D005260:Female; D005270:Femur Head / Q000473:pathology*; D005271:Femur Head Necrosis / Q000209:etiology / Q000473:pathology; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications* / Q000473:pathology; D006679:HIV Seropositivity / Q000150:complications* / Q000473:pathology; D006621:Hip Joint / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000209:etiology / Q000473:pathology; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000473:pathology / Q000821:virology; D012307:Risk Factors; D016896:Treatment Outcome