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The impact of asymptomatic human immunodeficiency virus (HIV)-positive disease status on inpatient complications following total joint arthroplasty: a propensity score-matched analysis

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

The number of patients with asymptomatic human immunodeficiency virus (AHIV) is increasing as the efficacy of antiretroviral therapy improves. While there is research on operative risks associated with having HIV, there is a lack of literature describing the impact of well-controlled HIV on postoperative complications. This study seeks to elucidate the impact of AHIV on postoperative outcomes after total hip (THA) and knee (TKA) arthroplasty.

Methods

The Nationwide Inpatient Sample was retrospectively reviewed for patients undergoing TKA and THA from 2005 to 2013. Subjects were subdivided into those with AHIV and those without HIV (non-HIV). Patient demographics, hospital-related parameters, and postoperative complications were all collected. One-to-one propensity score-matching, Chi-square analysis, and multivariate logistical regressions were performed to compare both cohorts.

Results

There were no significant differences between AHIV and non-HIV patients undergoing TKA or THA in terms of sex, age, insurance status, or total costs (all, p ≥ 0.081). AHIV patients had longer lengths of stay (4.0 days) than non-HIV patients after both TKA (3.3 days) and THA (3.1 days) (p ≤ 0.011). Both TKA groups had similar postoperative complication rates (p > 0.081). AHIV patients undergoing THA exhibited an increased rate of overall surgical complications compared non-HIV patients (0 vs. 4.5%, p = 0.043). AHIV was not associated with increased complications following both procedures.

Conclusion

Despite lengthier hospital stays among AHIV patients, baseline AHIV was not associated with adverse outcomes following TKA and THA. This adds to the literature and warrants further research into the impact of asymptomatic, well-controlled HIV infection on postoperative outcomes following total joint arthroplasty.

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Data availability

Publicly available datasets were used and/or analyzed in this study.

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Funding

No funds, grants, or other support was received.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY) Downstate Health Sciences University, 450 Clarkson Ave, MSC 30, Brooklyn, NY, 11203, USA

    Neil V. Shah, Matthew J. Lettieri, David Kim, Jack J. Zhou, Bassel G. Diebo, Colin Y. L. Woon & Qais Naziri

  2. College of Medicine, Drexel University, Philadelphia, PA, USA

    Nathaniel Pineda

  3. Department of Orthopaedic Surgery, Warren Alpert Medical School at Brown University, East Providence, RI, USA

    Bassel G. Diebo

Authors
  1. Neil V. Shah
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  2. Matthew J. Lettieri
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  3. David Kim
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  4. Jack J. Zhou
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  5. Nathaniel Pineda
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  6. Bassel G. Diebo
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  7. Colin Y. L. Woon
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  8. Qais Naziri
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Contributions

NVS, DK, BGD, and QN designed the review. NVS and MJL worked on methodology software, formal analysis, and investigation. NVS, BGD, and QN contributed to resources. The first draft of the manuscript was written by NVS and MJL, and all authors commented and contributed on previous versions of the manuscript. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Neil V. Shah.

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The authors have no relevant financial or non-financial conflicts of interest to declare.

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This study was performed in line with the principles of the Declaration of Helsinki. This study was found exempt from IRB approval.

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Shah, N.V., Lettieri, M.J., Kim, D. et al. The impact of asymptomatic human immunodeficiency virus (HIV)-positive disease status on inpatient complications following total joint arthroplasty: a propensity score-matched analysis. Eur J Orthop Surg Traumatol (2024). https://doi.org/10.1007/s00590-024-03872-3

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