Clinical efficacy of ERAS in patients with human immunodeficiency virus infection and femoral head necrosis undergoing total hip arthroplasty

Yiliyaer Batuer; MA Liang; SONG Yu-xia; Dilixiati Abulizi; TANG Wei; GU Fu-ding

doi:10.3969/j.issn.2095-252X.2025.03.010

Abstract：Objective To explore the application value of enhanced recovery after surgery(ERAS)in total hip arthroplasty(THA)for patients with human immunodeficiency virus infection and femoral head necrosis.Methods A retrospective analysis was conducted on the clinical data of 41 patients with HIV infection who underwent THA for osteonecrosis of the femoral head in our hospital from January 2020 to June 2023.The patients were divided into the control group(20 cases)and the study group(21 cases)according to the perioperative ERAS concept.The operation time,intraoperative blood loss,hospital stay,the first ambulation time after operation,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),procalcitonin(PCT),white blood cell(WBC)and other indicators before and 24 hours after operation,postoperative visual analogue scale(VAS)and postoperative Harris hip function score were compared between the two groups.Results The intraoperative blood loss was(97.14±9.56)ml in the study group and(150.50±15.72)ml in the control group,and the differences were statistically significant(P<0.001).The length of hospital stay was 9(8,10)days in the study group and 13(14,15)days in the control group,and the differences were statistically significant(P<0.001).The first ambulation time of the study group was 1 day after operation,and that of the control group was 4 days after operation,and the differences were statistically significant(P<0.001).The VAS score of the two groups at 12 hours after operation was(3.52±0.51)in the study group and(4.50±0.51)in the control group,and the differences were statistically significant(P<0.001).24 hours after operation,the study group was(2.57±0.51),and the control group was(3.50±0.51),and the differences were statistically significant(P<0.001).72 h after operation,the study group was(1.57±0.50),the control group was(2.50±0.51),and the differences were statistically significant(P<0.001);The Harris score of the two groups at 3 days after operation was(52.90±2.14)in the study group and(42.95±1.93)in the control group,and the differences were statistically significant(P<0.001).7 days after operation,the study group was(62.62±1.53),and the control group was(52.95±1.54),and the differences were statistically significant(P<0.001).There was no significant difference in erythrocyte sedimentation rate,C-reactive protein,procalcitonin,white blood cell and other indicators between the two groups before operation and 24 hours after operation(P>0.05).Conclusions The application of ERAS in THA patients with HIV infection and osteonecrosis of the femoral head can shorten the length of hospital stay,reduce medical costs,and relieve postoperative pain,which does not increase the risk of postoperative inflammatory response and complications.