Peer-review started: July 26, 2022
First decision: October 21, 2022
Revised: November 19, 2022
Accepted: December 8, 2022
Article in press: December 8, 2022
Published online: January 25, 2023
Processing time: 175 Days and 6.9 Hours
The incidence of human immunodeficiency virus (HIV)-infected cases that need total joint replacement (TJR) is generally rising. On the other hand, modern management of HIV-infected cases has enabled them to achieve longevity while increasing the need for arthroplasty procedures due to the augmented dege-nerative joint disease and fragility fractures, and the risk of osteonecrosis. Although initial investigations on joint replacement in HIV-infected cases showed a high risk of complications, the recent ones reported acceptable outcomes. It is a matter of debate whether HIV-infected cases are at advanced risk for adverse TJR consequences; however, the weak immune profile has been associated with an increased probability of complications. Likewise, surgeons and physicians should be aware of the complication rate after TJR in HIV-infected cases and include an honest discussion of the probable unwelcoming complication with their patients contemplating TJR. Therefore, a fundamental review and understanding of the interaction of HIV and arthroplasty are critical.
Core Tip: The outcome and prevalence of complications are controversial among human immunodeficiency virus-infected cases who need arthroplasty. According to our literature review, total joint replacement procedures are recommended based on patient-specific factors such as viral load, CD4+ T-cell count, clinical classification, history of intravenous drug addiction, and the patient's overall health. Optimization with antiviral drugs is also suggested before elective arthroplasty.