Background

It is unclear if hepatitis C virus (HCV) negatively impacts outcomes of revision total hip arthroplasty (rTHA). The purpose of this study is to trend recent rTHA utilization in patients who have HCV and compare postoperative complication rates versus a matched cohort.

Methods

All patients who underwent rTHA were retrospectively identified in a national database. Patients who had HCV (n = 1,746) were matched 1:3 with a matching group (n = 5,238) for age, gender, and several comorbidities. Cochran-Armitage tests were used to analyze trends in the annual proportion of rTHA performed in patients who had HCV from 2010 to 2019. Rates of 90-day medical and prosthesis-related complications within 2 years postoperatively were compared with multivariable logistic regressions.

Results

The annual proportion of rTHA performed in patients who had HCV significantly increased from 2010 to 2019 (P < .001). Patients who had HCV exhibited significantly higher rates of acute kidney injuries (7.6% versus 4.4%; odds ratio [OR] 1.50), transfusions (20.6% versus 14.6%; OR 1.38), and re-revisions for prosthetic joint infection (10.9% versus 6.5%; OR 1.73). In subgroup analyses, rates of re-revision for prosthetic joint infection after initial aseptic rTHA (7.1% versus 3.8%; OR 1.82) and periprosthetic fracture after initial septic rTHA (4.5% versus 1.6%; OR 2.77) were significantly higher in the HCV cohort.

Conclusion

Similar to primary THA, patients who have HCV exhibit significantly increased complication rates after rTHA. With growing utilization in recent years, these data suggest that this population will comprise an increasingly larger proportion of rTHA procedures performed in the coming years.

中文翻译：

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丙型肝炎与初始无菌和败血症翻修全髋关节置换术后较高的短期并发症发生率相关：一项匹配队列研究

背景

目前尚不清楚丙型肝炎病毒 (HCV) 是否会对翻修全髋关节置换术 (rTHA) 的结果产生负面影响。本研究的目的是了解近期 rTHA 在 HCV 患者中的使用趋势，并将术后并发症发生率与匹配队列进行比较。

方法

所有接受 rTHA 的患者都在国家数据库中进行了回顾性识别。感染 HCV 的患者 (n = 1,746) 与匹配组 (n = 5,238) 按 1:3 的比例匹配年龄、性别和几种合并症。Cochran-Armitage 检验用于分析 2010 年至 2019 年期间在 HCV 患者中进行 rTHA 的年度比例趋势。将术后 2 年内 90 天医疗和假体相关并发症的发生率与多变量逻辑回归进行比较。

结果

从 2010 年到 2019 年，HCV 患者每年进行 rTHA 的比例显着增加 ( P < .001)。感染 HCV 的患者出现急性肾损伤（7.6% 对 4.4%；比值比 [OR] 1.50）、输血（20.6% 对 14.6%；OR 1.38）和因假体关节感染再次翻修（10.9%对比 6.5%；或 1.73）。在亚组分析中，初始无菌性 rTHA 后假体关节感染的再次翻修率（7.1% 对 3.8%；OR 1.82）和初始感染性 rTHA 后假体周围骨折（4.5% 对 1.6%；OR 2.77）在 HCV 中显着更高队列。

结论

与初次 THA 相似，HCV 患者在 rTHA 后并发症发生率显着增加。随着近年来使用率的提高，这些数据表明这一人群将在未来几年执行的 rTHA 手术中占越来越大的比例。