HIV positive patient undergoes successful bilateral total knee replacement surgery

HIV patients are at a high risk considering their immunocompromised status. Proper evaluation and optimisation of HIV drugs and assessment of early warning signs helps in managing the condition

A 61 year old, HIV positive patient successfully underwent a bilateral total knee replacement surgery at Fortis Hospital, Bannerghatta road.  Dr Srinivas JV- Director of Orthopaedics-Fortis Hospitals, Bannerghatta road along with Dr Sheela Chakravarthy-Director, Internal Medicine and Dr Venkatesh S- Consultant, Interventional Cardiology,led the team of doctors.

The patient visited Fortis Hospital, Bannerghatta road with a complaint of severe pain in both knees. Post diagnosis, the doctor found that she was suffering from severe osteoarthritis in both knees along with an underlying HIV positive status. Since the last five months, she was unable to do her day-to-day activities including walking, bending and squatting.

Dr Srinivas JV, Director of Orthopaedics, Fortis Hospital, Bannerghatta Road said,  “The patient was suffering from severe knee pain which had affected her daily routine and activities like walking and bending knees. As the patient is HIV positive, we performed a fitness and preoperative evaluation before recommending total knee replacement surgery. Post consulting Dr Sheela Chakravarthy and Dr Venkatesh S, we went ahead with the surgery. The patient withstood the procedure well and was mobilised with full weight bearing walking with a walker post operation. The patient was discharged after a week post surgery and we advised her to continue physiotherapy along with proper rest of 3-4 weeks.

Dr Sheela Chakravarthy-Director, Internal Medicine, Fortis Hospital, Bannerghatta Road said, “HIV patients are at a high risk considering their immunocompromised status. Proper evaluation and optimisation of HIV drugs and assessment of early warning signs helps in managing the condition. This helps in giving them a chance to lead a normal life and manage their complications better with the help of highly skilled orthopaedic surgeons. Additionally, an intensive care unit enables to manage early setbacks expected because of HIV disease”

NCBI states that “there are challenges in the management of inflammatory arthritis in patients who are HIV-positive, which includes difficulties in assessing the disease activities and limited information about the safety of immunosuppressive drugs in these individuals. Rheumatic diseases are very common in patients who are infected with HIV. The HIV virus can cause many of the symptoms of arthritis and rheumatic diseases. Some joint and muscle related diseases can result from HIV infection affecting any age group. Sometimes it can also occur due to the medicines consumed to keep a control on HIV.

Rheumatic diseases can cause a lot of discomfort, weakness and improper functioning. It is important to inform the doctor if a patient experiences joint pain or muscle weakness while consuming the HIV drugs. People with HIV should follow a well-balanced diet along with healthy eating habits and following a proper exercise regime.