Hepatitis C infection and complication rates after total shoulder arthroplasty in United States veterans

Favian Su, Charles J. Cogan, Ilya Bendich, Ning Zhang, Mary A. Whooley, Alfred C. Kuo

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: Few studies have evaluated the effect of hepatitis C (HCV) on primary total shoulder arthroplasty (TSA). Our purpose was to determine if HCV infection is associated with increased complication rates after TSA in United States (US) veterans and, secondarily, to determine if preoperative HCV treatment with direct-acting antivirals (DAAs) affects postoperative complication rates. Methods: US Department of Veterans Affairs (VA) data sets were used to retrospectively identify patients without HCV, patients with untreated HCV, and patients with HCV treated with DAAs who underwent TSA from 2014 to 2019. Medical and surgical complications were assessed using International Classification of Diseases codes. Complication rates between patients with HCV (treated and untreated) and patients without HCV and between HCV-treated patients and HCV-untreated patients were compared at 90 days and 1 year after surgery. Results: We identified 5774 primary TSAs that were performed at VA hospitals between 2014 and 2019. A minority (9.5%) of TSA patients had HCV, 23.4% of whom were treated preoperatively with DAAs. On multivariate analysis, HCV patients had increased odds of 1-year medical complications (odds ratio, 1.39; 95% confidence interval, 1.06-1.81, P = .016), when compared with patients without HCV. No statistically significant difference in complication rates was observed between HCV-treated and HCV-untreated patients. Discussion: US veterans with a history of HCV are at an increased risk of developing medical but not surgical complications within the first year after TSA. Larger studies are necessary to evaluate the effects of DAA treatment on complication rates.

Original languageEnglish
Pages (from-to)699-706
Number of pages8
JournalJSES International
Issue number4
StatePublished - Jul 2021


  • Complications
  • Direct-acting antiviral
  • Hepatitis C
  • Level III
  • Surgical outcomes
  • Total shoulder arthroplasty
  • Veterans
  • retrospective cohort Comparison using large database
  • treatment study


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