Ultra-congruent (UC) polyethylene liners are designed to add additional anterior-posterior stability in primary total knee arthroplasties (TKAs), compensating for actual or potential posterior cruciate ligament incompetence, somewhat like a posterior stabilized knee. The literature supports patella resurfacing in primary posterior-stabilized-compared to cruciate-retaining (CR)-TKA due to higher revision rates with non-resurfaced patella. However, it is unclear if UC liners alter patella-related revisions. The aim of the study was to compare patella revision rates and survivorship of UC versus CR liners in primary TKA without patella resurfacing using two common prostheses in patients who had osteoarthritis.

Revision total knee arthroplasties (rTKAs) are being performed more frequently in the United States in younger patients. Few large studies have evaluated the effect of age following rTKA. The study sought to evaluate the effect of age on rTKA outcomes.

Extended oral antibiotic (EOA) prophylaxis has been shown to reduce rates of periprosthetic joint infection (PJI) in high-risk patients following total knee arthroplasty (TKA). Although national societies' recommendations against their use and clinical efficacy remain controversial, the increase in the literature surrounding EOA prophylaxis suggests a potential change in practice patterns that may warrant the creation of national guidelines. The purpose of this study was to investigate the trends in the utilization of EOA prophylaxis following TKA from 2010 to 2022.

Minority patients have been shown to underutilize total knee arthroplasty (TKA) compared to non-Hispanic White (NHW) patients. Specific drivers of this underutilization have not been identified. We sought to determine if racial concordance between patient and physician is associated with the surgeon's likelihood to recommend TKA.

Periprosthetic joint infections (PJIs) are common and serious complications following knee and hip arthroplasty. Our previous retrospective study suggested extended antibiotics following debridement, antibiotics, and implant retention (DAIR) decreased failure rates and were not associated with increased adverse events (AEs) as compared to a standard 6 weeks of antibiotic therapy. Further, extended antibiotics beyond one year did not provide additional benefits. These observations were tested in this prospective cohort study.

Despite the broad utilization of aspirin as a venous thromboembolism (VTE) chemoprophylactic agent following total knee (TKA) and total hip arthroplasty (THA), few studies have evaluated its safety and efficacy in patients who had a history of VTE. This study sought to evaluate the safety and efficacy of aspirin relative to enoxaparin in high-risk total joint arthroplasty (TJA) patients.

Mortality rates following total hip (THA) and total knee (TKA) arthroplasty display distinct temporal patterns, often attributed to patient selection bias, perioperative optimization, and co-morbidities. Understanding these mortality patterns is essential for epidemiological and health-economic longitudinal modeling.

Retrospective data supporting the use of tranexamic acid (TXA) among high-risk total joint arthroplasty (TJA) patients is limited by surgeon selection bias. This study sought to evaluate the thromboembolic risk associated with TXA administration among elective arthroplasty patients who have history of venous thromboembolism (VTE) while accounting for surgeon selection.

Venous thromboembolism (VTE) and dislocation are well-described complications following total hip arthroplasty (THA). However, the relationship between THA dislocation and VTE remains unclear. This study sought to determine the risk of deep vein thrombosis (DVT) and pulmonary embolism (PE) in patients who experience a hip dislocation and subsequent closed reduction following primary THA.

Mental illness is a known risk factor for poor postoperative outcomes following total knee arthroplasty (TKA); however, a diagnosed mental illness does not always reflect the current state of a patient's mental health. Using the preoperative Patient-Reported Outcomes Measurement Information System (PROMIS)-10 Mental Health T-score (MHT), the purpose of this study was to understand the association between mental health and a patient's immediate inpatient recovery pattern following TKA.

A tourniquet is commonly used during total knee arthroplasty (TKA) to improve surgical field visibility and minimize blood loss. While the short-term effects of tourniquet use on postoperative outcomes have been studied extensively and found to be minimal, its influence on longer-term outcomes remains underexplored. This study examined tourniquet use in TKA with up to five-year follow-up.

Bilateral unicompartmental knee arthroplasty (bUKA) done on the same day (simultaneous) (sbUKA) has been shown to be safe and cost-effective in hospital settings. Given the popularity and increased use of ambulatory surgery centers (ASC), the purpose of this study was to compare safety and patient-reported outcome measures (PROMs) of sbUKA done at the hospital versus ASC.

Recent evidence suggests extended courses of oral antibiotics (EOA) after total hip (THA) and knee (TKA) arthroplasty may reduce the risk of periprosthetic joint infection (PJI) in high-risk patients. EOA rates after THA have risen significantly. However, there is a lack of epidemiologic data on EOA prophylaxis following TKA. Therefore, we investigated national trends in EOA prophylaxis for primary TKA and whether these rates were reflective of changes in patient risk or prescribing practices.

Periprosthetic joint infection (PJI) with sepsis is a life-threatening condition and identification of synchronous foci of infection is challenging. Positron emission tomography using F-fluorodeoxyglucose combined with computed tomography (F-FDG-PET/CT) is useful to detect PJI in elective, non-septic patients. We hypothesized that in patients who have PJI and concomitant sepsis requiring intensive care, F-FDG-PET/CT could accurately identify synchronous foci of infection. We addressed the following questions: (1) How often were synchronous foci of infection detected? (2) What were the confirmation rates of these infection foci by other complementary state-of-the-art methods? (3) Did F-FDG-PET/CT findings result in surgical treatment? and (4) What is the risk of synchronous PJI in patients who have PJI and concomitant sepsis who have another indwelling arthroplasty?

Tranexamic acid (TXA) is a renally-excreted antifibrinolytic commonly utilized in total joint arthroplasty (TJA). This study examined whether TXA administration affected clinical outcomes and kidney function in patients who had end-stage renal disease (ESRD) undergoing TJA or hemiarthroplasty.

Despite their effectiveness in postoperative analgesia regimens for total knee arthroplasty (TKA) and total hip arthroplasty (THA), opioid medications are accompanied by well-known side effects and a risk of long-term dependence. These drawbacks have prompted the exploration of opioid-free analgesia protocols. The purpose of this study was to summarize the nature and extent of evidence available on opioid-free analgesia protocols in THA and TKA management.

Healthcare delivery systems throughout the United States have transitioned to a value-based care model, shifting away from a fee-for-service model to instead emphasize patient health outcomes and the quality of medical care. Social determinants of health (SDOH) have been shown to have a large impact on patient health outcomes and thus, must play an integral role in the implementation of a value-based model. This is of particular interest in the field of lower extremity joint arthroplasty, where demand is rising in conjunction with expanded access to care. This article intends to: 1) provide background on SDOH in the setting of value-based arthroplasty care; 2) explore the impact of SDOH on patient outcomes and costs following total joint arthroplasty (TJA); and 3) provide strategies for recognizing and addressing SDOH in practice.