title: Total hip arthroplasty in HIV-infected patients: a retrospective, controlled study.
abstract: BACKGROUND
  Although HIV-infected patients are at greater risk of presenting with ischaemic necrosis of the femoral head, there have been concerns about whether total hip arthroplasty (THA) may have worse outcomes than expected.
  
  
  METHODS
  From the Orthopedic and Trauma Surgery database we identified all patients who had undergone THA because of ischaemic necrosis of the femoral head from January 2001 until March 2010. Patient's diagnosis of HIV infection was confirmed at the time of arthroplasty by cross-matching with the HIV unit database. For every THA in HIV-infected patients, two THAs in patients not known to be HIV-infected, with the same diagnosis of ischaemic necrosis of the femoral head and having undergone surgery over the same period, were randomly selected. THAs were compared in HIV- and non-HIV-infected patients for surgical procedure, in-patient stay and long-term prognosis.
  
  
  RESULTS
  There were 18 THAs in 13 HIV-infected patients and 36 THAs in 27 non-HIV-infected patients. No significant differences were observed in the mean time spent in surgery (106 vs. 109 minutes, respectively; P = 0.66), the need for red cell transfusion (1 vs. 4, respectively; P = 0.48) or the mean duration of hospitalization (7.8 vs. 9.4 days, respectively; P = 0.48). The two groups showed similar postoperative functional results, which were maintained until the end of the follow-up period (median 3.3 years in the HIV-positive group and 5.8 years in the HIV-negative group).
  
  
  CONCLUSIONS
  Our study suggests that the outcome of THA in HIV-positive patients is not worse than that of HIV-negative patients, although future research on larger numbers of patients is required to confirm this.
authors.affiliation: Department of Orthopedic and Trauma Surgery, Hospital Clínic, Barcelona, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Tornero
authors.forename: S
authors.initials: S
authors.lastname: García
authors.forename: M
authors.initials: M
authors.lastname: Larrousse
authors.forename: X
authors.initials: X
authors.lastname: Gallart
authors.forename: G
authors.initials: G
authors.lastname: Bori
authors.forename: J
authors.initials: J
authors.lastname: Riba
authors.forename: J
authors.initials: J
authors.lastname: Rios
authors.forename: Jm
authors.initials: J
authors.lastname: Gatell
authors.forename: E
authors.initials: E
authors.lastname: Martinez
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects*; D019644:Arthroplasty, Replacement, Hip / Q000706:statistics & numerical data*; D005260:Female; D005271:Femur Head Necrosis / Q000139:chemically induced / Q000473:pathology* / Q000601:surgery / Q000821:virology; D005500:Follow-Up Studies; D006679:HIV Seropositivity / Q000150:complications / Q000473:pathology*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D019380:Anti-HIV Agents