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      Human immunodeficiency virus in total hip arthroplasty

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          Abstract

          • Human immunodeficiency virus (HIV) is a pandemic affecting more than 35 million people worldwide. The aim of this review is to describe the association between HIV and total hip arthroplasty (THA) and assess patient risk factors to optimize functional outcomes and decrease rates of revision.

          • Since the advent of highly active antiretroviral treatment (HAART), HIV-infected patients are living longer, which allows them to develop degenerative joint conditions. HIV and HAART act independently to increase the demand for THA. HIV-positive patients are also more predisposed to developing avascular necrosis (AVN) of the hip and femoral neck fractures due to decreased bone mineral density (BMD).

          • Prior to the widespread implementation of access to HAART in homogenous cohorts of HIV-infected patients undergoing THA, reports indicated increased rates of complications. However, current literature describes equivocal functional outcomes and survival rates after THA in HIV-positive patients controlled on HAART when compared to HIV-negative controls.

          • HIV-infected patients eligible for THA should be assessed for medical co-morbidities and serum markers of disease control should be optimized.

          • Periprosthetic joint infection (PJI) is a leading cause of revision THA, and HIV is a modifiable risk factor. Importantly, the significance is negated once patients are placed on HAART and achieve viral suppression.

          • THA should not be withheld in HIV-infected patients injudiciously. However, HIV is a burgeoning epidemic and all patients should be identified and started on HAART to avoid preventable peri-operative complications.

          Cite this article: EFORT Open Rev 2020;5:164-171. DOI: 10.1302/2058-5241.5.190030

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          Cigarette smoking prevalence among adults with HIV compared with the general adult population in the United States: cross-sectional surveys.

          The negative health effects of cigarette smoking and HIV infection are synergistic.
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            Revision surgery after total joint arthroplasty: a complication-based analysis using worldwide arthroplasty registers.

            The authors performed a complication-based analysis of total knee (TKA), total hip (THA), and total ankle arthroplasty (TAA) using worldwide arthroplasty registers. We extracted data with respect to reason for revision surgery and pooled causes. The most common causes for revisions in THA were aseptic loosening (55.2%), dislocation (11.8 %), septic loosening (7.5%), periprosthetic fractures (6%), and others. The most common causes in TKA were aseptic loosening (29.8%), septic loosening (14.8%), pain (9.5%), wear (8.2%), and others. The most common causes in TAA were aseptic loosening (38%), technical errors (15%), pain (12%), septic loosening (9.8%), and others. Revisions in TKA and THA differ with respect to type of complication. However, in case of TAA, higher rates of technically related complications are reported. Copyright © 2013 Elsevier Inc. All rights reserved.
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              Adult antiretroviral therapy guidelines 2017

              These guidelines are intended as an update to those published in the Southern African Journal of HIV Medicine in 2014 and the update on when to initiate antiretroviral therapy in 2015. Since the release of the previous guidelines, the scale-up of antiretroviral therapy (ART) in southern Africa has continued. New antiretroviral drugs have become available with improved efficacy, safety and robustness. The guidelines are intended for countries in the southern African region, which vary between lower and middle income.
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                Author and article information

                Journal
                EFORT Open Rev
                EFORT Open Rev
                EFORT Open Reviews
                British Editorial Society of Bone and Joint Surgery
                2058-5241
                March 2020
                2 March 2020
                : 5
                : 3
                : 164-171
                Affiliations
                [1 ]Arthroplasty Unit, Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), Johannesburg, South Africa
                Author notes
                [*]Jurek Rafal Tomasz Pietrzak, Department of Orthopaedics, University of the Witwatersrand, 7 York Road, Parktown, South Africa. Email: jrtpietrzak@ 123456yahoo.com
                Author information
                https://orcid.org/0000-0001-9172-911X
                Article
                10.1302_2058-5241.5.190030
                10.1302/2058-5241.5.190030
                7144891
                c6c489c0-a473-4422-a56c-7093cf97fd5f
                © 2020 The author(s)

                This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) licence ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed.

                History
                Categories
                Hip
                9
                Human Immunodeficiency Virus
                Immunocompromise
                Total Hip Arthroplasty

                human immunodeficiency virus,immunocompromise,total hip arthroplasty

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