Cemented femoral fixation for total hip arthroplasty (THA) in those aged ≥ 65 years has potential benefits. However, few resources exist to assist in selecting cemented femoral implant designs. We examined the associated risk for all-cause revision, risk of periprosthetic femoral fracture, and aseptic loosening based on a modern classification of cemented femoral stem designs.

Distal femoral replacement (DFR) is increasingly used for periprosthetic distal femoral fractures (PDFF). Although infection and aseptic loosening are known complications, predictors, particularly of loosening, remain poorly defined in non-oncologic populations. This study aimed to identify patient risk factors for aseptic loosening and infection following DFR for PDFF in a non-oncologic cohort. Additionally, DFR utilization trends for PDFF were assessed over time.

Patients who have a body mass index (BMI) over 40 face unique risks when undergoing joint arthroplasty. Although unicompartmental knee arthroplasty (UKA) may offer benefits such as reduced recovery time, its safety profile in morbidly obese populations remains unclear. This study compared postoperative complication rates between UKA and total knee arthroplasty (TKA) in patients who had a BMI above 40.

Osteonecrosis of the femoral head (ONFH) is a progressive and disabling condition of the hip joint that primarily affects young and active individuals, leading to progressive collapse of subchondral bone and often secondary arthritis. Despite extensive investigation, the precise etiology often remains unclear. While high-dose corticosteroids, chronic alcohol ingestion, and smoking are known associated risk factors, approximately 20 to 30% of ONFH cases are classified as idiopathic. Recently, the concept of gut dysbiosis, i.e., disruption of the normal intestinal microbial balance, has gained increasing attention due to its systemic immunologic and metabolic implications. Dysbiosis is associated with an increase in gut permeability, leading to the translocation of bacteria and their metabolic products, including lipopolysaccharides and short-chain fatty acids (SCFAs), into the systemic circulation. This may stimulate proinflammatory cascades throughout the body, including the joints, initiating a bone remodeling process. Emerging evidence from preclinical and human research suggests that specific gut microbiota taxa may influence key mechanisms involved in the pathogenesis of ONFH. Additionally, early findings support the therapeutic potential of microbiota-targeted therapies such as probiotics, SCFAs-enriched diets, and fecal microbiota transplantation (FMT). Although a growing number of descriptive studies support this link, the current evidence remains associative rather than causal, as no longitudinal cohort studies have confirmed this relationship. Future investigations are needed to establish causality between gut dysbiosis and ONFH. To our knowledge, this review offers the first comprehensive synthesis of the literature aiming to explore current evidence and the potential link between gut dysbiosis and ONFH, highlighting future directions for microbiome-based therapeutic interventions.

There is increasing interest in socioeconomic deprivation and its influence on outcomes in orthopaedics. This study aimed to examine the relationship between neighborhood-level social deprivation and its impact on 90-day readmission, length of stay, and all-cause revision after primary total knee arthroplasty (TKA) and total hip arthroplasty (THA).

Surgeon and surgeon experience may influence clinical outcomes in both total knee arthroplasty (TKA) and total hip arthroplasty (THA). Clinical outcomes can be integrated with costs to calculate value. We aimed to determine if surgeon experience and volume were associated with increased value in arthroplasty.

The rising prevalence of knee arthroplasty (KA) affects daily life, especially for working-age patients who have high expectations for resuming activities. Variability in guidelines and lack of personalized recovery recommendations highlight the need for improved guidance, such as through eHealth solutions. This study identifies the most important daily activities chosen in an eHealth application and evaluates patients' recovery times compared to expert recommendations.

Creating optimal training environments for future academic leaders in arthroplasty is a topic of increasing interest. This study determined the training characteristics associated with future academic faculty appointments after arthroplasty fellowship training.

Ceramic heads used in revision total hip arthroplasty (rTHA) typically utilize a titanium sleeve adapter to protect from damage by the retained femoral stem taper; however, there is sparse mid- to long-term data on this practice, and risk factors for failure remain relatively unknown. The purpose of this study was to determine revision-free survival, specifically for failure of the head and/or neck junction (HNJ) and all-cause re-revision in this patient population, and to identify factors associated with failure.

The optimal timing for initiating direct oral anticoagulants (DOACs) for venous thromboembolism (VTE) prophylaxis following revision total hip arthroplasty (rTHA) is unknown. This study compared rates of thromboembolic and bleeding complications between patients beginning prophylactic courses of apixaban or rivaroxaban on postoperative day (POD) zero versus POD one.

Social support improves outcomes after total hip and knee arthroplasty (THA/TKA), but the demands on informal caregivers, especially as surgeries transition to outpatient care, are understudied. This study strived to assess caregiver burden, predictors, and implications following joint arthroplasty.

Vaccinations against common respiratory pathogens are recommended for the general population. However, associations between respiratory vaccinations and outcomes following total joint arthroplasty (TJA) have not been investigated.

Major depressive disorder (MDD) is a psychiatric condition characterized by persistent low mood, anhedonia, sleep disturbances, guilt, fatigue, impaired concentration, appetite changes, psychomotor abnormalities, and suicidal ideation. It is a prevalent comorbidity among patients undergoing total knee arthroplasty (TKA) and may affect recovery. While prior research has emphasized pain and functional outcomes, the broader impact of MDD on postoperative psychiatric, systemic, and mortality outcomes remains underexplored. This study investigated whether MDD is independently associated with increased risk of newly diagnosed psychiatric, somatic, and mortality complications following primary TKA.

The Centers for Medicare & Medicaid Services (CMS) now requires patient-reported outcome measures (PROMs) collection after total hip arthroplasty (THA), emphasizing substantial clinical benefit (SCB) in the Hip Disability and Osteoarthritis Outcome Score - Joint Replacement (HOOS-JR). This study aimed to establish SCB thresholds for HOOS Pain, Physical Function Short Form (PS), and JR, and to identify factors influencing SCB achievement after THA.

Agonists targeting the glucagon-like peptide-1 receptor have gained prominence in treating individuals who have type 2 diabetes and obesity. However, their influence on postoperative medical complications following total joint arthroplasty remains poorly characterized.

Diagnosing acute periprosthetic joint infection (PJI) soon after surgery presents a challenge because the inflammation caused by the procedure can mimic that of an infection. Key diagnostic measures include synovial white blood cell (WBC) count, polymorphonuclear percentage (PMN%), and alpha-defensin (AD). Nonetheless, the precise thresholds, particularly for infections with low virulence, remain ambiguous. This research assessed the effectiveness of synovial absolute neutrophil count (ANC) in diagnosing acute PJI in hip and knee joints and established specific thresholds based on the procedure and the organism involved.

The rising use of unicompartmental knee arthroplasty (UKA) among various Western countries raises questions regarding the multifaceted determinants driving this trend. Therefore, this study aimed to examine trends and their associations with three-year survivorship, focusing on patient, implant, hospital, and revision-related factors.

Testosterone is a prothrombotic hormone, but the effect of exogenous testosterone on venous thromboembolic events (VTE) following total joint arthroplasty (TJA) remains unclear. This study investigated the association between testosterone replacement therapy (TRT) and postoperative risk of VTE following primary total hip arthroplasty (THA) and total knee arthroplasty (TKA).

This study aimed to establish a claims-based timeline for recovery following unilateral total knee arthroplasty (TKA), including the impact of comorbidities and postoperative complications such as motion-restoring surgery and joint contracture.

Postoperative concerns after total joint arthroplasty (TJA) frequently lead to emergency department (ED) visits, increasing costs, and affecting outcomes. To reduce unnecessary ED use, our institution implemented a Total Joint Hotline (TJH) to triage patient concerns. The purpose of this study was to determine if the TJH effectively reduced avoidable ED visits.

The presence of acetabular dysplasia or femoro-acetabular impingement increases the chance of an earlier total hip arthroplasty (THA). Surprisingly, the influence of femoral and acetabular parameters on the age at which THA is required remains poorly investigated. The aim of this study was to evaluate the radiographic hip morphotype at the time of THA using an artificial intelligence (AI)-based analysis to assess potential differences.