SCIENTIFIC PAPER Total Knee and Hip Replacements for Patients with Haemophilia Who Are Seropositive for Human Immunodeficiency Virus

Objective: To evaluate the outcome of primary total joint replacements in patients with haemophilia who are seropositive for HIV. Patients and Methods: This study retrospectively reviewed the results of 7 total knee replacements and 3 total hip replacements performed in 6 HIV-positive patients with haemophilia, with a mean follow-up period of 6 years. Results: Three knees were complicated by early haemarthrosis and the final range of motion and function were poor. Another patient had severe insert-wear 8 years post-surgery. The remaining 3 knees were uncomplicated. All knees had excellent pain relief except for the 1 with severe insert wear. One hip became infected and converted to excision arthroplasty 7 years post-surgery. The other 2 hips had good to excellent results. Two patients had low CD4 lymphocyte counts (≤400 x 10 6 /L), but neither were complicated by infection. The only patient who developed an infection had a normal CD4 count. Conclusion: Joint replacement for HIV-positive patients with haemophilia generally results in good pain relief. However, the complication rate is high and the functional results vary. A lower CD4 count did not seem to be related to infection.