We evaluated the surgical complications following hip and knee arthroplasty in patients who were seropositive for hepatitis C in a matched study.
Methods: Seventy-one patients with hepatitis C underwent forty total hip arthroplasties and thirty-two total knee arthroplasties from 1995 to 2006. The patients had normal preoperative liver function tests. Patients with human Selleckchem GSK2126458 immunodeficiency virus infection, hepatitis B, and hemophilia were excluded. A control group was matched in a 2:1 ratio with the hepatitis-C group for age, body-mass index, sex, year of surgery, and medical comorbidities, including diabetes, rheumatoid arthritis, and immunosuppressive
Results: In the group of patients with hepatitis C who were managed with total hip arthroplasty, six patients (15%) had wound complications requiring oral antibiotics or wound irrigation and debridement and four hips (10%) had mechanical complications, including implant loosening or dislocation. In the control group, three patients (3.8%) had wound complications requiring oral antibiotics or irrigation and debridement
and three patients (3.8%) had mechanical complications, including dislocation, peri prosthetic femoral fracture, and implant failure. In the group of patients with hepatitis C who underwent total knee arthroplasty, three patients (9.4%) had mechanical complications, including loosening and pen-prosthetic fracture requiring revision. Selleck GW786034 In the control group, three patients (4.7%) had wound complications, one (1.6%) had a deep infection requiring two-stage revision, and one (1.6%) underwent revision because of a mechanical problem. The combined hepatitis-C group had significantly longer hospital stays and higher rates of surgical and mechanical complications, reoperation, and revision.
Patients with hepatitis C undergoing joint arthroplasty had a higher rate of surgical complications and a longer hospital stay. The reason for the higher rate of complications in this group of patients is unknown, and further investigation is needed. Patients with hepatitis C should be counseled about the potential for PLX4032 a higher incidence of postoperative complications prior to undergoing joint arthroplasty.”
“Purpose of reviewExtracorporeal membrane oxygenation (ECMO) has been employed as a management strategy to support the failing pulmonary allograft following lung transplantation. We review the indications, technical considerations, management strategies, and outcomes of using ECMO after lung transplantation.Recent findingsECMO is typically indicated for early pulmonary allograft failure despite optimized conventional support measures.