Nonsurgical Management of Severe Osteonecrosis of the Knee in an HIV-Positive Patient: A Case Report

Due to the life-prolonging effects of combination antiretroviral therapy, many people with HIV are living longer. However, this enhanced longevity is often mirrored by increased disability resulting from HIV and/or the adverse effects of medication. Management of HIV-positive patients is further com...

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Main Authors: Stephanie A. Nixon, Kelly K. O'Brien, Gary Rubin
Format: Article
Language:English
Published: Wiley 2011-01-01
Series:Case Reports in Infectious Diseases
Online Access:http://dx.doi.org/10.1155/2011/935041
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author Stephanie A. Nixon
Kelly K. O'Brien
Gary Rubin
author_facet Stephanie A. Nixon
Kelly K. O'Brien
Gary Rubin
author_sort Stephanie A. Nixon
collection DOAJ
description Due to the life-prolonging effects of combination antiretroviral therapy, many people with HIV are living longer. However, this enhanced longevity is often mirrored by increased disability resulting from HIV and/or the adverse effects of medication. Management of HIV-positive patients is further complicated by comorbidities related to aging, including bone and joint disorders. In this paper, we describe the nonsurgical management of an HIV-positive patient with premature onset of severe osteonecrosis of the knee. A 50-year-old man who had been HIV-positive for 16 years and on combination antiretroviral therapy for 11 years presented to his family physician with extreme discomfort in his right knee. He was diagnosed with osteonecrosis of the right knee, but resisted total knee arthroplasty because of potential complications under anesthesia related to comorbid advanced liver disease. Instead, a successful combination of non-surgical management strategies was employed by the patient and his health care team.
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spelling doaj-art-46ba47b6af614b0e8b64dcd522ef17fe2025-08-20T03:36:13ZengWileyCase Reports in Infectious Diseases2090-66252090-66332011-01-01201110.1155/2011/935041935041Nonsurgical Management of Severe Osteonecrosis of the Knee in an HIV-Positive Patient: A Case ReportStephanie A. Nixon0Kelly K. O'Brien1Gary Rubin2Department of Physical Therapy, University of Toronto, 160-500 University Avenue, Toronto, ON, M5G 1V7, CanadaDepartment of Physical Therapy, University of Toronto, 160-500 University Avenue, Toronto, ON, M5G 1V7, CanadaDepartment of Family and Community Medicine, University of Toronto, Toronto, ON, M5T 1W7, CanadaDue to the life-prolonging effects of combination antiretroviral therapy, many people with HIV are living longer. However, this enhanced longevity is often mirrored by increased disability resulting from HIV and/or the adverse effects of medication. Management of HIV-positive patients is further complicated by comorbidities related to aging, including bone and joint disorders. In this paper, we describe the nonsurgical management of an HIV-positive patient with premature onset of severe osteonecrosis of the knee. A 50-year-old man who had been HIV-positive for 16 years and on combination antiretroviral therapy for 11 years presented to his family physician with extreme discomfort in his right knee. He was diagnosed with osteonecrosis of the right knee, but resisted total knee arthroplasty because of potential complications under anesthesia related to comorbid advanced liver disease. Instead, a successful combination of non-surgical management strategies was employed by the patient and his health care team.http://dx.doi.org/10.1155/2011/935041
spellingShingle Stephanie A. Nixon
Kelly K. O'Brien
Gary Rubin
Nonsurgical Management of Severe Osteonecrosis of the Knee in an HIV-Positive Patient: A Case Report
Case Reports in Infectious Diseases
title Nonsurgical Management of Severe Osteonecrosis of the Knee in an HIV-Positive Patient: A Case Report
title_full Nonsurgical Management of Severe Osteonecrosis of the Knee in an HIV-Positive Patient: A Case Report
title_fullStr Nonsurgical Management of Severe Osteonecrosis of the Knee in an HIV-Positive Patient: A Case Report
title_full_unstemmed Nonsurgical Management of Severe Osteonecrosis of the Knee in an HIV-Positive Patient: A Case Report
title_short Nonsurgical Management of Severe Osteonecrosis of the Knee in an HIV-Positive Patient: A Case Report
title_sort nonsurgical management of severe osteonecrosis of the knee in an hiv positive patient a case report
url http://dx.doi.org/10.1155/2011/935041
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AT garyrubin nonsurgicalmanagementofsevereosteonecrosisofthekneeinanhivpositivepatientacasereport