Does Preoperative Antiviral Treatment for Hepatitis C Decrease Risk of Complications After Total Hip Arthroplasty? A Matched Cohort Study

Authors

• Austin J. Ross, Tulane University School of Medicine, New Orleans, LA
• Bailey J. Ross, Tulane University School of Medicine, New Orleans, LA
• Olivia C. Lee, LSU Health Sciences Center - New OrleansFollow
• Hunter W. Hood, Tulane University School of Medicine, New Orleans, LA
• Fernando L. Sanchez, Tulane University School of Medicine, New Orleans, LA
• William F. Sherman, Tulane University School of Medicine, New Orleans, LA

Document Type

Article

Publication Date

3-3-2022

Publication Title

Journal of Arthroplasty

Abstract

Background: Hepatitis C virus (HCV) is associated with increased complication risk after elective arthroplasty. The purpose of this study is to examine the impact of HCV and prearthroplasty antiviral treatment on complications following total hip arthroplasty (THA). Methods: A retrospective matched cohort study was conducted using an administrative claims database. In total, 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 2 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 < .01). At 2 years postoperatively, HCV patients also exhibited significantly higher risk of revision THA (odds ratio [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 2 years postoperatively relative to controls (all P > .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 2 years postoperatively (OR 0.62). Conclusion: HCV patients exhibit significantly increased risk of medical and joint complications following THA relative to controls, though prearthroplasty antiviral treatment mitigates complication risk. Treated HCV patients exhibited significantly lower risk of inpatient readmission and PJI compared to untreated HCV patients. Level of Evidence: Level III.

First Page

1326

Last Page

1332.e3

PubMed ID

35248753

Volume

37

Issue

7

Rights

© 2022 Published by Elsevier Inc.

Recommended Citation

Ross, Austin J.; Ross, Bailey J.; Lee, Olivia C.; Hood, Hunter W.; Sanchez, Fernando L.; and Sherman, William F., "Does Preoperative Antiviral Treatment for Hepatitis C Decrease Risk of Complications After Total Hip Arthroplasty? A Matched Cohort Study" (2022). School of Medicine Faculty Publications. 4624.
https://digitalscholar.lsuhsc.edu/som_facpubs/4624
10.1016/j.arth.2022.02.102