There is increasing awareness of and concern about the treatment of HIV-infected patients with painful joint arthropathy. Orthopaedic surgeons and hospitals face the challenge of providing optimal treatment in the most cost effective way. The purpose of this study was to determine the most effective way of treating arthropathy in HIV-infected patients and to document the complications.

Twelve HIV-positive patients with a mean age of 45 years underwent THA. Assessment of nutritional status showed a mean serum albumen of 300 g/l. The mean haemoglobin was 11. The ESR was elevated in all cases, with a mean of 92 mm/hour Westergren and mean CD4 count of 455.

At follow-up (mean 36 months) all patients were fully ambulant, with no signs of infection. Nevertheless, the decision to perform total joint replacement in HIV-positive patients should be taken with utmost care. The outcome depends on a number of factors, including nutritional status, coexisting medical problems and the stage of the disease.