Timing optimal pour l’arthroplastie totale de hanche programmée chez les patients HIV + - 23/08/18
Optimal timing for elective total hip replacement in HIV-positive patients
Abstract |
Introduction |
Evidence about the optimal timing for total hip replacement (THR) in HIV-positive patients is scant.
Hypothesis |
Preoperative criteria: cluster of differentiation 4(CD4)counts>200 cells/mm3 and an undetectable HIV virus load before THR, improve infection rates, aseptic loosenings, and functional outcomes.
Materials and methods |
We recruited 16 HIV-positive patients who had undergone 25THRs between 2003 and 2015. None had hemophilia, and none were intravenous drug users (IVDUs).
Results |
Their mean age was 41.2years (range: 24–60); minimum follow-up was 12months (mean: 64.6); mean duration of prophylactic antibiotics was 2.9 days (range: 1–5); and mean hospital length of stay was 6.0 days (range: 4–11). No patients were treated with subsequent oral antibiotics. The mean preoperative CD4 count was 464.1±237.0 (range: 235–904) cells/mm3. There were no early superficial surgical site infections, late periprosthetic joint infections, or aseptic loosenings. Post-surgery Harris Hip score was significantly (p<0.001) better.
Discussion |
A preoperative CD4 count>200cell/mm3 and an undetectable HIV virus load might indicate optimal timing for elective THRs in HIV-positive patients without hemophilia and not IVDUs.
Level of evidence |
IV, retrospective or historical series.
Le texte complet de cet article est disponible en PDF.Keywords : HIV, Total hip replacement, Infection
| ☆ | Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology : Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus. |
Vol 104 - N° 5
P. 472 - septembre 2018 Retour au numéro
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