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Risks of Hip Replacement in Hiv patients
May 25, 2004

It has been an ongoing battle for me to find a doctor to do a hip replacement on me in CT. The first orthopedic surgeon I was directed to was going to do it. Even had a date set up, then all of a sudden he said that the risks were to great and that he suggested decompression. I was taken aback because at our first meeting he had dismissed all options except for hip replacement. However since I had waited this long and had no more patience to wait for on getting a second opinion, I went on ahead and had the decompression done. By the way, I was diagnosed with avasculor neucrosis, which it seems alot of us long timers are getting now. Anyway, 12 weeks have gone by and i am worse off than better, and on as much pain medications as my body can physically take and then some. I was directed to another orthopedic surgeon, who took another x-ray and it showed a significant degeneration of the femur bone. However, this guy didnt like the repour we had together!! I find it hard to believe that after only 5 minutes of telling him the history of my hip, he could get such an impression. So, now my HIV doctor is telling me to write him a Sorry letter, cause he is a great doctor. Now Im going on 5 months, and am in great great pain, and still havent been able to get a hip replacement. Sorry to go on and on,,my question to you is, what are these major risks of infection,and how careful do I have to be, once I finally get the surgery done. What do I need to look out for? Please Give Me Some advice Sir, cause Im really getting quite depressed over this whole situation.

Response from Dr. Boyle

Presuming that your CD4 count is OK (roughly >200) and you don't have any other health issues (e.g., diabetes), the risks should be minimal. Some studies indicate a slight increase in risk of infection, but this is not so high that the surgery should not be performed. In fact, several of my patients have had their hips replaced (one patient had both done) without any complications or problems. Sorry you have had such trouble, but keep looking since and if you need to consider coming to NYC where it is much more routinely done.



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