Treatment Outcomes of Periprosthetic Joint Infection in HIV-positive Patients

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Abstract

Relevance. There is a limited number of publications reporting outcomes of primary large joint arthroplasty in patients with human immunodeficiency virus (HIV). The authors were unable to find papers on revision arthroplasty in patients with periprosthetic infection. Purpose of the study — to evaluate short term outcomes after revision arthroplasty in HIV-positive patients with periprosthetic infection of the hip and knee joint. Materials and methods. 13 HIV-positive patients with periprosthetic infection of the hip (10 cases) and knee (3 cases) joint underwent treatment in the period from 2015 to 2019. Patients were examined by clinical, laboratory and roentgenological methods. Harris Hip Score and Knee Society Score were used for evaluation prior to and after the surgery. Results. Mean follow up period was 21,4±2,6 months. Successful two-stage treatment was performed in two (15,4%) out of 13 patients with periprosthetic infection. In 5 cases (38,5%) control over infection was achieved by resection arthroplasty, and in one case (7,7%) – by arthrodesis. Five patients (38,5%) refused from interchange of spacer to prosthesis. Mean Harris Hip score demonstrated insignificant increase postoperatively — from 45,3±2,2 to 52,2±4,15 (р = 0,2). Conclusion. Despite following the international protocols for treatment of implant-associated infection the infection recurrence rate in HIV-positive patients in the asymptomatic phase remains very high. Efficiency of twostage treatment using antibacterial spacers in the present group of patients amounted only to 15,4%.

About the authors

A. S. Tryapichnikov

Ilizarov Russian Scientific Center “Restorative Traumatology and Orthopedics”

Author for correspondence.
Email: pich86@bk.ru

Aleksandr S. Tryapichnikov — Cand. Sci. (Med.), Junior Research Fellow, Laboratory for Reconstructive Joint Replacements and Arthroscopy

Kurgan

Russian Federation

A. M. Ermakov

Ilizarov Russian Scientific Center “Restorative Traumatology and Orthopedics”

Email: fake@neicon.ru

Artem M. Ermakov — Cand. Sci. (Med.), Orthopedic Surgeon, Bone Infection Department no. 1

Kurgan

Russian Federation

N. M. Klyushin

Ilizarov Russian Scientific Center “Restorative Traumatology and Orthopedics”,
Tyumen State Medical University

Email: fake@neicon.ru

Nikolay M. Klyushin — Dr. Sci. (Med.), Head of “Clinic of Purulent Osteology”,

Kurgan;

Professor, Department of Postgraduate Education

Tyumen

Russian Federation

Yu. V. Ababkov

Ilizarov Russian Scientific Center “Restorative Traumatology and Orthopedics”

Email: fake@neicon.ru

Yuriy V. Ababkov — Cand. Sci. (Med.), Head of Purulent Trauma and Orthopaedic Department no. 1

Kurgan

Russian Federation

A. B. Stepanayn

Ilizarov Russian Scientific Center “Restorative Traumatology and Orthopedics”

Email: fake@neicon.ru

Artak B. Stepanayn — Orthopedic Surgeon, Purulent Trauma and Orthopaedic Department no. 1

Kurgan

Russian Federation

A. N. Koyushkov

Ilizarov Russian Scientific Center “Restorative Traumatology and Orthopedics”

Email: fake@neicon.ru

Andrey N. Koyushkov — Orthopedic Surgeon, Purulent Trauma and Orthopaedic Department no. 1

Kurgan

Russian Federation

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