Outcomes of Total Hip Arthroplasty Performed for HIV-Associated Osteonecrosis in China: A Retrospective Cohort Study

Background: In the post-epidemic era, Acquired Immune Deficiency Syndrome (AIDS) remains one of the most prevalent and detrimental infectious diseases worldwide. The incidence of osteonecrosis of the femoral head (ONFH) in AIDS patients is 100 times higher than that in healthy individuals. Although Total Hip Arthroplasty (THA) is ultimately necessary for most patients, there is still a dearth of evidence regarding its safety and efficacy in Chinese AIDS patients. Methods: The clinical data of 49 patients who met the inclusion and exclusion criteria were retrospectively analyzed. Simultaneously, we categorized patients whose hemoglobin and albumin met a specific threshold as the optimized group and performed group comparisons. Results: There are statistical differences in Harris score and VAS score pre- and post-operation, with a low overall complication rate. Notably, no disparities were observed between the optimized group and the partial optimized group in terms of overall conditions, laboratory examination indicators, severity of ONFH, surgical outcomes, surgical complications, pain perception or functional limitations. Furthermore, no correlation was found between CD4+ T lymphocytes and hemoglobin levels, albumin levels, white blood cell count, or platelet count. Conclusion: THA is safe and effective in Chinese AIDS patients with ONFH. However, optimal treatment has limited efficacy in AIDS patients undergoing THA for ONFH. The reconsideration and evaluation of the predictive value of CD4+ T lymphocytes for postoperative complications in joint replacement procedures is warranted.