title: Does HIV Infection Increase the Risk of Short-Term Adverse Outcomes Following Total Knee Arthroplasty?
abstract: Using the Nationwide Inpatient Sample, we assess the: (1) demographic trends; (2) complications; and (3) length of hospital stay among total knee arthroplasty (TKA) patients with and without human immunodeficiency virus (HIV). The study population consisted of 2772 patients with HIV and 5,672,314 controls. Patients with HIV were more likely to be younger, male, and nonwhite. Patients with HIV were at an increased risk for perioperative wound infections (OR=2.78; P=0.024), although they were not at an increased risk for overall complications (OR=1.21; P=0.321). Mean length of stay was 17% longer for patients with HIV (P<0.001). Given these findings, orthopedic surgeons should have a low threshold to work up a patient with HIV for a wound infection following TKA.
authors.affiliation: Department of Orthopaedics, SUNY Downstate Medical Center, Brooklyn, New York; Department of Epidemiology and Biostatistics, SUNY Downstate Medical Center, Brooklyn, New York.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Boylan
authors.affiliation: Department of Orthopaedics, SUNY Downstate Medical Center, Brooklyn, New York.
authors.forename: Niladri
authors.initials: N
authors.lastname: Basu
authors.affiliation: Department of Orthopaedics, SUNY Downstate Medical Center, Brooklyn, New York.
authors.forename: Qais
authors.initials: Q
authors.lastname: Naziri
authors.affiliation: Department of Orthopaedic Surgery, Seton Hall University School of Health and Medical Sciences, South Orange, New Jersey.
authors.forename: Kimona
authors.initials: K
authors.lastname: Issa
authors.affiliation: Department of Orthopaedics, SUNY Downstate Medical Center, Brooklyn, New York.
authors.forename: Aditya V
authors.initials: AV
authors.lastname: Maheshwari
authors.affiliation: Rubin Institute for Advanced Orthopaedics, Center for Joint Preservation and Reconstruction, Sinai Hospital of Baltimore, Baltimore, Maryland.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Mont
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010343:Patient Admission; D011183:Postoperative Complications / Q000453:epidemiology*; D011184:Postoperative Period; D012307:Risk Factors; D014946:Wound Infection
keywords: HIV; TKA; complications; total knee arthroplasty; wound infection