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Abstract Details
Does Preoperative Antiviral Treatment for Hepatitis C Decrease Risk of Complications After Total Hip Arthroplasty? A Matched Cohort Study
Arthroplasty. 2022 Mar 3;S0883-5403(22)00253-4. doi: 10.1016/j.arth.2022.02.102.Online ahead of print.
Austin J Ross1, Bailey J Ross1, Olivia C Lee2, Hunter W Hood1, Fernando L Sanchez1, William F Sherman3
Author information
Tulane University School of Medicine, Department of Orthopaedic Surgery, 1430 Tulane Ave, New Orleans, LA 70112, USA.
Tulane University School of Medicine, Department of Orthopaedic Surgery, 1430 Tulane Ave, New Orleans, LA 70112, USA; Louisiana State University School of Medicine, Department of Orthopaedic Surgery & Southeast Louisiana Veterans Health Care System, New Orleans, LA 70119, USA.
Tulane University School of Medicine, Department of Orthopaedic Surgery, 1430 Tulane Ave, New Orleans, LA 70112, USA. Electronic address: Swilliam1@tulane.edu.
Abstract
Background: Hepatitis C (HCV) is associated with increased complication risk after elective arthroplasty. The purpose of this study was to examine the impact of HCV and pre-arthroplasty antiviral treatment on complications following total hip arthroplasty (THA).
Methods: A retrospective matched cohort study was conducted using an administrative claims database. 6,883 HCV patients were matched 1:3 with 20,694 noninfected controls, and 920 HCV patients with antiviral treatment before THA (treated HCV) were matched 1:4 with 3,820 HCV patients without treatment (untreated HCV). Rates of 90-day medical complications and joint complications within two years postoperatively were compared with multivariable logistic regression.
Results: HCV patients exhibited significantly increased rates of medical complications within 90 days compared to noninfected controls (all p < 0.01). At two years postoperatively, HCV patients also exhibited significantly higher risk of revision THA (OR 1.81), dislocation (OR 2.06), mechanical complications (OR 1.40), periprosthetic fracture (OR 1.76), and prosthetic joint infection (PJI) (OR 1.79). However, treated HCV patients exhibited statistically comparable risk of all joint complications at two years postoperatively relative to controls (all p > 0.05). Compared to untreated HCV patients, treated HCV patients exhibited significantly lower risk of inpatient readmission within 90 days (OR 0.58) and PJI at two years postoperatively (OR 0.62).
Conclusion: HCV patients exhibit significantly increased risk of medical and joint complications following THA relative to controls, though pre-arthroplasty antiviral treatment mitigates complication risk. Treated HCV patients exhibited significantly lower risk of inpatient readmission and PJI compared to untreated HCV patients.