Large joint surgeries, hip and knee arthroplasties, are often performed in individuals with hepatitis C infection. Hepatitis C has been identified as one of risk factors for the post-operative complications. There is scarcity of the data about the role of pre-operative hepatitis C treatment in decreasing the post-operative complications for patients undergoing hip and knee arthroplasties.
The retrospective review of the patient with hepatitis C infection who have undergone hip and knee arthroplasties from 2008 to 2015. Diagnosis of Hepatitis C was made based on the positive viral load. The study population is divided into two groups based on the sustained virologic response (SVR) after the hepatitis C treatment prior to the hip and knee arthroplasty surgery and those who did not have treatment prior to surgery. The baseline demographic data, laboratory parameters (Table 1) and post-operative course were reviewed from electronic medical records. AIM: To compare the post-operative outcomes for hip and knee arthroplasties, in patients with hepatitis C infection, based on prior hepatitis C treatment status (Table 2).
There were 1187 hip and knee arthroplasties performed during study period. 11% of patients (n = 129) were positive for hepatitis C infection. In our study population hepatitis C infection is identified as the risk factor for post-operative infections. Among the patients with the hepatitis C infection 18.6% (n = 24) had received treatment with SVR prior to surgery. All patients were treated with the direct acting anti-viral agents (DAA). The mean age of the patients was 55 years and they were predominantly males (75%). The base line demographic and laboratory parameters were comparable between the two groups, except for serum albumin level, which was lower in patients with no prior hepatitis C treatment. The patients with liver cirrhosis were equally distributed in both groups. The patients with prior hepatitis C infection consistently demonstrated higher rates for post-operative complications including infection, bleeding and impaired would healing, whereas “zero” post-operative complications (infections, joint bleeding or wound dehiscence) were noted for the patients who had prior hepatitis C treatment with SVR.
This retrospective review of patients with hepatitis C undergoing the hip and knee arthroplasties demonstrates a protective effect for post-operative complications in patients with prior hepatitis C treatment and SVR.