Clinical and patient-reported outcomes following total hip arthroplasty in patients with chronic hepatitis C were comparable to outcomes of patients without the infection at a mean 6-year follow-up, according to a presenter at the American Academy of Orthopaedic Surgeons Annual Meeting.
“Hepatitis C can affect approximately 3% of orthopedic patients, many of whom undergo total joint arthroplasty,” said Samik Banerjee, MBBS, MS, MRCS (Glasg), of the Department of Orthopaedic Surgery and Center for Joint Preservation and Replacement at the Rubin Institute for Advanced Orthopedics and Sinai Hospital of Baltimore. “However, there has been a paucity of reports on the outcomes of primary total hip arthroplasty in patients with hepatitis C.”
Similar implant survivorship
Banerjee and his colleagues compared the clinical and patient-reported outcomes of 49 patients (54 hips) who underwent primary total hip arthroplasty (THA) to a matched cohort of 148 THAs in patients without hepatitis C. All patients underwent THA during 2002 to 2011. Patients with hepatitis C included 10 women and 39 men who had a mean age of 57 years. Mean follow-up was 6 years, and the underlying cause of hip disease was end-stage osteoarthritis in 49 hips and avascular necrosis in five. Patients were matched according to age, gender, body mass index, cause of hip disease and mean follow-up duration.
Overall implant survivorship was statistically similar between the groups: 98% in the patients with hepatitis C and 98.5% in the matched control group. “The hepatitis C group had one aseptic revision, while the matched cohort had two revisions during this period,” Banerjee said during his presentation.
Researchers also found no difference between the groups in the postoperative Harris hip score, with an improvement to a mean of 89 points in the patients with hepatitis C and an improvement to a mean of 90 points in the comparison group.
Superficial infection, hematoma
Banerjee and colleagues also reported no significant differences in the complication rate between the groups, but in the hepatitis C group, he and his colleagues found a superficial infection and two wound hematoma cases. Furthermore, they found no differences in the SF-36 physical and mental component scores or UCLA activity scores. Postoperative radiographic evaluation revealed no component malalignment, symptomatic progressive radiolucencies, change in component position or implant subsidence.
“From our study, we can agree [with previously published data] that there is no difference in aseptic implant survivorship, activity levels or functional outcomes after THA,” Banerjee said. “We believe that a prior history of chronic hepatitis C alone may not predict inferior clinical outcomes, and we also believe more prospective studies are necessary to better evaluate these outcomes.” – by Tina DiMarcantonio
Banerjee S. Paper #5. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 11-15, 2014; New Orleans.
For more information:
Samik Banerjee, MBBS, MS, MRCS (Glasg), can be reached at the Department of Orthopaedic Surgery, Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, 2401 W. Belvedere Ave., Baltimore, MD 21205; email: email@example.com
Banerjee has no relevant financial disclosures.