Severe Bilateral Avascular Necrosis of Femoral Heads in an HIV-Positive Patient: A Rare Case Report and Literature Review | ||
| The Egyptian Orthopaedic Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 25 September 2025 | ||
| Document Type: Case Report | ||
| DOI: 10.21608/eoj.2025.413428.1072 | ||
| Authors | ||
| Yash Gulati1; Raju Vaishya* 2; Vibhu Bahl3; Abhishek Vaish4 | ||
| 1Department of Orthopaedics and Joint Replacement Surgery, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi 110076, India | ||
| 2Department of Orthopaedics and Joint Replacement Surgery, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi 110076, India | ||
| 3Department of Orthopaedics and Joint Replacement Surgery, Indraprastha apollo Hospitals, Sarita Vihar, New Delhi 110076, India | ||
| 4Department of Orthopaedics, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi 110076, INDIA | ||
| Abstract | ||
| Introduction: Avascular necrosis (AVN) is a debilitating complication observed in HIV-positive individuals, leading to significant morbidity. Bilateral AVN of the femoral heads in an HIV-positive patient is exceptionally uncommon, with only a handful of cases documented globally.The pathogenesis involves both general risk factors and HIV-specific mechanisms. Case Presentation: A 55-year-old male from Mozambique, diagnosed with HIV 23 years ago, experienced progressive bilateral hip pain over three years. He presented with a severe waddling gait, and imaging revealed extensive destruction of both femoral heads. Laboratory tests indicated regular inflammatory markers, and histopathology showed mild chronic inflammation without malignancy. The patient underwent staged bilateral uncemented total hip arthroplasty (THA). At three months post-surgery, the patient was pain-free, able to ambulate independently, and follow-up radiographs demonstrated well-positioned prostheses. Conclusion: This case illustrates the increased risk of AVN in HIV-positive individuals and the successful use of surgical intervention to restore function. Regular monitoring of hip replacements is crucial for long-term success. | ||
| Keywords | ||
| Avascular Necrosis; HIV; Total Hip Arthroplasty; Osteonecrosis; Antiretroviral Therapy | ||
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