Why the study?
Hepatitis C virus is associated with increased complication risk after arthroplasty, but the impact of HCV and pre-arthroplasty antiviral treatment on complications following total shoulder arthroplasty remained to be examined.
Does pre-arthroplasty antiviral treatment for hepatitis C reduce complication rates after total shoulder arthroplasty in patients with HCV?
Does pre-arthroplasty antiviral treatment for hepatitis C reduce complication rates after total shoulder arthroplasty in patients with HCV?
Pre-arthroplasty antiviral treatment for hepatitis C is associated with significantly reduced rates of 90-day medical complications and 2-year prosthetic joint infections following total shoulder arthroplasty.
Answers are grounded in this paper and cite their sources.
HCV may elevate TSA complication risk; hypothesis-generating for antiviral pretreatment benefits.
Background Hepatitis C virus (HCV) is associated with increased complications of risk after arthroplasty. The purpose of this study was to examine the impact of HCV and a pre-arthroplasty antiviral treatment on complications following total shoulder arthroplasty (TSA). Methods A retrospective matched cohort study was conducted using an administrative claims database. Patients who underwent TSA were identified with Current Procedural Terminology -23472 and International Classification of Diseases procedural codes. A total of 1244 HCV patients were matched 1:3 with 3732 noninfected controls across age, sex, diabetes mellitus, tobacco use, and obesity. The HCV patients with treatment before TSA were identified by claims containing antiviral drug codes. Multivariable logistic regression was used to compare rates of 90-day medical complications and prosthesis-related complications within 2 years postoperatively for (1) HCV patients vs. controls, (2) antiviral-treated HCV patients vs. controls, and (3) antiviral-treated HCV patients vs. untreated HCV patients. Results Patients with HCV exhibited significantly higher rates of blood transfusion (OR 2.12), acute kidney injuries (OR 1.86), inpatient readmission (OR 2.06), revision TSA (OR 1.48), dislocation (OR 1.92), mechanical complications (OR 1.39), and prosthetic joint infection (OR 1.53) compared to controls. Antiviral-treated HCV patients exhibited a significantly lower rate of myocardial infarction (OR 0.27) and comparable rates of all other complications relative to controls (all P > .05). Compared to untreated HCV patients, antiviral-treated HCV patients exhibited significantly lower rates of 90-day medical complications (OR 0.57) and prosthetic joint infection (OR 0.36). Conclusions HCV is associated with significantly increased complication rates after TSA. Antiviral treatment before TSA may reduce the risk of postoperative complications.
No takes yet. Share an insight, caveat, or question.
Ross et al. (2022) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: