L’infection par le virus de l’hépatite C augmente le risque de complications après une arthroplastie : une méta-analyse d’études observationnelles - 15/09/21

Hepatitis C virus infection increases the risk of adverse outcomes following joint arthroplasty: A meta-analysis of observational studies

Doi : 10.1016/j.rcot.2021.04.023

Tao Cheng ^a,^{^{1
Tao Cheng and Liang Hao are the joint corresponding authors.},}^⁎ , Chao Yang ^a, Liang Hao ^b,^{^{1
Tao Cheng and Liang Hao are the joint corresponding authors.}}, Xigao Cheng ^b, Jianjun Hu ^c, Weiping Ren ^d, Xianlong Zhang ^a
^a Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Shanghai Sixth People's Hospital, No. 600, Yishan Road, Xuhui District, 200233 Shanghai, République populaire de Chine
^b Department of Orthopaedic Surgery, The Second Affiliated Hospital of Nanchang University, No.1, Minde Road, Donghu District, 330006 Nanchang, République populaire de Chine
^c Department of Infectious Disease, Shanghai Jiao Tong University Affiliated Shanghai Sixth People's Hospital, No.600 Yishan Road, Xuhui District, 200233 Shanghai, République populaire de Chine
^d Department of Biomedical Engineering, Wayne State University, 818W. Hancock Avenue, 48201 Detroit, MI, États-Unis

^⁎Auteur correspondant.

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Wednesday 15 September 2021
This article has been published in an issue click here to access

Abstract

Background

Whether hepatitis C virus (HCV)-positive patients are at risk for increased complications and long hospital stay following total joint arthroplasty (TJA) remains unclear. Therefore, we performed a meta-analysis aiming to answer the following question: 1) are there differences in postoperative complications including joint infection and mortality between patients with or without hepatitis C following TJAs?; 2) are patients without HCV be associated with less blood loss, shorter hospital stay, lower readmission rate, higher function scores, lower revision and reoperation rates than patients with HCV?

Methods

A meta-analysis was conducted to pool data and quantitatively assessing the association between HCV infection and risks for adverse postoperative outcomes. A systematic search of all published studies concerning HCV and TJA was performed in five bibliographic databases, including PubMed, EMBASE, China National Knowledge Infrastructure, Web of Science, and the Cochrane Library databases. Random-effects meta-analysis of odds ratios (OR) was accomplished according to the classification of adverse events, subgroup analyses were performed based on surgery type.

Results

Fifteen eligible observational studies were included with a sample size of 9,788,166 patients. Overall pooled data revealed the increased risk of overall complications, including medical and surgical complications, in HCV-positive patients undergoing TJA compared with than in HCV-negative people (OR 1.57; 95% CI: 1.44–1.71 [p<0.00001]). Joint infections were highly common in HCV-positive patients undergoing lower-extremity TJA (OR 2.06; 95% CI: 1.73–2.47 [p<0.00001]). Furthermore, HCV infections were associated with high rates of reoperations and revisions (OR 1.47; 95% CI: 1.40–1.55 [p<0.00001]).

Conclusions

Patients with hepatitis C have an increased risk of adverse outcomes post-TJA and a high risk of reoperation and revision that is partially attributed to postoperative complications, particularly joint infections.

Level of evidence

III; systematic review and meta-analysis.

El texto completo de este artículo está disponible en PDF.

Keywords : Hepatitis C, Joint arthroplasty, Complication, Infection, Reoperation

☆	Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus.