Knee and hip arthroplasty infection rates in persons with haemophilia: a 27 year single center experience during the HIV epidemic

Haemophilia. 2005 May;11(3):233-9. doi: 10.1111/j.1365-2516.2005.01081.x.

Abstract

Total joint replacement (TJR) is an option for the management of chronic haemophilic arthropathy. Because surgery is technically challenging, there is a high rate of deep prosthetic infections, particularly in human immunodeficiency virus (HIV)-infected individuals. We determined the incidence of deep infection rates following total knee and hip arthroplasties in HIV-seropositive and HIV-seronegative persons with haemophilia. Fifty-one primary joint replacements were performed on 32 patients seen at a regional comprehensive haemophilia care center from 1975 to 2002. Thirty prostheses were placed in patients who were HIV-seropositive prior to surgery (n = 14) or seroconverted later (n = 16). Median age at the time of surgery was 33 years (range: 20-61) among 19 HIV-seropositive patients and 35 years (range: 26-74) among 13 HIV-negative patients. Median duration of follow-up was 83 months (range: 2-323). Rate of primary joint infection per artificial joint-year by HIV status was compared by Poisson regression. Main outcome measures were the incidence of primary replacement joint infections by HIV status. Deep infections developed in five (9.8%) of 51 replacement joints. There were two infections during 204.15 joint-years without HIV infection and three infections during 205.28 joint-years with HIV infection. The incidence rate of joint infection (0.98 vs. 1.46 per 100 joint-years) was not increased with HIV (relative risk, RR: 1.49, 95% CI: 0.25-8.93, P = 0.66). We conclude that HIV infection is not a contraindication to knee or hip replacement arthroplasty in the appropriate clinical setting.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antiretroviral Therapy, Highly Active / methods
  • Arthroplasty, Replacement, Hip / methods*
  • Arthroplasty, Replacement, Knee / methods*
  • Escherichia coli Infections / etiology
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • HIV Infections / mortality
  • HIV Seropositivity / complications
  • HIV Seropositivity / microbiology
  • HIV-1
  • Hemarthrosis / etiology
  • Hemarthrosis / surgery*
  • Hemophilia A / complications*
  • Hemophilia A / mortality
  • Hemophilia A / surgery
  • Hip Joint / microbiology
  • Humans
  • Joint Diseases / etiology
  • Joint Diseases / microbiology
  • Joint Diseases / mortality
  • Knee Joint / microbiology
  • Male
  • Middle Aged
  • Postoperative Hemorrhage / etiology
  • Postoperative Hemorrhage / microbiology
  • Postoperative Hemorrhage / mortality
  • Staphylococcal Infections / etiology
  • Surgical Wound Infection / etiology*
  • Surgical Wound Infection / mortality
  • Treatment Outcome