Does Hepatitis C Affect the Clinical and Patient-reported Outcomes of Primary Total Hip Arthroplasty at Mid-term Follow-up?

Abstract Background It is estimated that 3 to 6% of orthopaedic patients, many of whom many undergo lower extremity total joint arthroplasty, are infected with hepatitis C. The purpose of this study was to assess the outcomes of patients with Hepatitis C who undergo THA in comparison to a matched co...

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Bibliographic Details
Published in:The Journal of arthroplasty 2017
Main Authors: Issa, Kimona, MD, Pierce, Todd P., MD, Harwin, Steven F., MD, Scillia, Anthony J., MD, McInerney, Vincent K., MD, Mont, Michael A., MD
Format: Article
Language:English
Subjects:
Orthopedics
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Summary:Abstract Background It is estimated that 3 to 6% of orthopaedic patients, many of whom many undergo lower extremity total joint arthroplasty, are infected with hepatitis C. The purpose of this study was to assess the outcomes of patients with Hepatitis C who undergo THA in comparison to a matched control cohort in terms of: (1) patient-reported outcomes; (2) implant survivorship; and (3) complications. Methods Fifty-four hips in 49 hepatitis C-infected patients who underwent a primary THA between 2002 and 2011 were reviewed. This included 10 women and 39 men who had a mean age of 57 years and a mean 6.5-year follow-up. These patients were matched to 163 THAs (148 patients) who did not have this disease and underwent a THA during the same time-period. We compared implant survivorship, complication rates, Harris hip scores (HHS), and University of California Los Angeles (UCLA) activity scores. Radiographs were evaluated for loosening, fracture, malalignment, and osteolysis. Results The implant survivorship in the hepatitis C infected patients and comparison group were 96.2 and 98.7%. The risk of revision surgery in the hepatitis C cohort was 3-fold higher than the comparison group, however, this difference was not significant (p=0.26). The hepatitis C infected cohort had higher risk of surgical complications (OR=6.5; p=0.034). There were no differences in post-operative HHS or UCLA activity scores between the cohorts. Conclusions Hepatitis C patients can achieve good implant survivorship and clinical outcomes following THA. However, these patients may be at an increased risk for surgical complications and revision rate.
ISSN:0883-5403
DOI:10.1016/j.arth.2017.04.001