The Fate of the DAIR, Outcomes After One Year: a large database study.

Debridement with antibiotics and implant retention (DAIR) is commonly utilized for prosthetic joint infection (PJI) for total knee arthroplasty (TKA); particularly in cases of acute PJI 1. Reported success rates of DAIR have been highly variable, but the overall success rate of DAIR cohort studies is ~70-80% 2. However, no large database studies have investigated the success rate of DAIR.

Joint Injection or Aspiration before Total Knee Arthroplasty: Does It Increase the Risk of Periprosthetic Joint Infection?

Injections are a common preoperative treatment for patients who eventually undergo total knee arthroplasty (TKA). However, recent studies have shown a relationship between preoperative injections and adverse outcomes following surgery. The purpose of this study was to characterize the type of intra-articular procedure patients receive in the acute period prior to surgery and determine their association with postoperative periprosthetic joint infection (PJI).

Cost Difference in Performing Total Knee Arthroplasty at Ambulatory Surgical Centers Compared With Hospital-Based Outpatient Departments: Observational Study.

Background: As total knee arthroplasty (TKA) further transitions toward an outpatient procedure, it becomes important to identify the resource utilization after TKAs at different outpatient facilities. The objective of this study was to determine the 90-day cost of patients who underwent TKAs at an ambulatory surgical center (ASC) or a hospital outpatient department (HOPD).

Methods: An observational cohort study was conducted using the Marketscan database with patients who had a TKA at an ASC or HOPD between January 1st, 2019, and October 2nd, 2021.

Antibiotic Prophylaxis Prior to Dental Procedures After Total Hip and Knee Arthroplasty Does Not Decrease the Risk of Periprosthetic Joint Infection.

Background: Periprosthetic joint infection (PJI) is a devastating complication after total hip and total knee arthroplasty (THA/TKA). While some guidelines no longer recommend routine use of prophylactic antibiotics for dental procedures, many surgeons continue to prescribe antibiotics for their THA/TKA patients. In a setting of increasing antibiotic resistance, it is important to reduce unnecessary antibiotic use.

joint isolates: Whole-genome sequencing demonstrates evidence of hospital transmission and common antimicrobial resistance.

Objective: We investigated genetic, epidemiologic, and environmental factors contributing to positive joint cultures.

Design: Retrospective cohort study with whole-genome sequencing (WGS).

Patients: We identified isolates from hip or knee cultures in patients with 1 or more prior corresponding intra-articular procedure at our hospital.

Venous Thromboembolism in Total Hip and Total Knee Arthroplasty.

Importance: The optimal pharmacologic thromboprophylaxis agent after total hip and total knee arthroplasty is uncertain and consensus is lacking. Quantifying the risk of postoperative venous thromboembolism (VTE) and bleeding and evaluating comparative effectiveness and safety of the thromboprophylaxis strategies can inform care.

Objective: To quantify risk factors for postoperative VTE and bleeding and compare patient outcomes among pharmacological thromboprophylaxis agents used after total hip and knee arthroplasty.

Risk Factors for Surgical Site Complications After Outpatient Lumbar Spine Surgery.

With the recent increase of minor lumbar spine surgeries being performed in the outpatient setting, there is a need for information on factors that contribute to post-operative complications for these surgeries. This was a prospective observational study examining risk factors for self-reported post-operative drainage in patients who underwent lumbar spine surgery. Patient surveys and the hospital's electronic medical records were used to collect data on patient demographic, patient lifestyle, and surgical variables.

Erratum: Whole-genome sequencing to assess clonality in a series of prosthetic joint Staphylococcus epidermidis isolates - WITHDRAWAL.

[This corrects the article DOI: 10.1017/ash.2022.

A Safe Number of Perioperative Opioids to Reduce the Risk of New Persistent Usage Among Opioid-Naïve Patients Following Total Joint Arthroplasty.

Background: Higher initial opioid dosing increases the risk of prolonged opioid use following total joint arthroplasty (TJA), and the safe amounts to prescribe are unknown. We examined the relationship between perioperative opioid exposure and new persistent usage among opioid-naïve patients after total knee and hip arthroplasty.

Methods: In this retrospective cohort study, 22,310 opioid-naïve patients undergoing primary TJA between 2018 and 2019 were identified within a commercial claims database.

Effect of the COVID-19 Pandemic on Rates of Ninety-Day Peri-Prosthetic Joint and Surgical Site Infections after Primary Total Joint Arthroplasty: A Multicenter, Retrospective Study.

The impact of the coronavirus 2019 (COVID-19) pandemic on the rate of primary total joint arthroplasty (TJA) peri-prosthetic joint infection (PJI) and superficial surgical site infections (SSI) is currently unknown. The purpose of this multicenter study was to evaluate any changes in the rates of 90-day PJI or 30-day SSI, including trends in microbiology of the infections, during the COVID-19 pandemic compared to the three years prior. An Institutional Review Board-approved, multicenter, retrospective study was conducted with five participating academic institutions across two healthcare systems in the northeastern United States.

Drivers of Unequal Healthcare Costs in the Nonoperative Treatment of Late-Stage Knee Osteoarthritis Prior to Primary Total Knee Arthroplasty.

Background: In the United States, patients with late-stage knee osteoarthritis (OA) often undergo several nonoperative treatments and related procedures prior to total knee arthroplasty. The costs of these treatments and procedures are substantial, and the variation in healthcare costs among different groups of patients may exist. The purpose of this study is to examine these costs and determine the drivers of costs in patients with the highest healthcare expenditure.

Elimination of Routine Urinalysis before Elective Orthopaedic Surgery Reduces Antibiotic Utilization without Impacting Catheter-associated Urinary Tract Infection or Surgical Site Infection Rates.

Purpose: Routine preoperative urinalysis has been the standard of care for the orthopedic population for decades, regardless of symptoms. Studies have demonstrated antibiotic overuse and low concordance between bacteria cultured from the surgical wound and the urine. Testing and treatment of asymptomatic urinary tract colonization before total joint arthroplasty (TJA) is unnecessary and increases patient risk.

Risk factors for surgical site infections in knee and hip arthroplasty patients.

We performed a retrospective cohort study to identify risk factors for surgical site infection (SSI) in patients with hip and knee arthroplasty in a high-volume orthopedic center with low overall SSI rates. Active smoking and revision arthroplasty both increased the risk for SSI. Former smokers were seen to have a lower SSI risk, demonstrating a potential benefit in implementing mandated smoking secession programs.

Addressing decontaminated respirators: Some methods appear to damage mask integrity and protective function.

Decontamination of N95 respirators is being used by clinicians in the face of a global shortage of these devices. Some treatments for decontamination, such as some vaporized hydrogen peroxide methods or ultraviolet methods, had no impact on respiratory performance, while other treatments resulted in substantial damage to masks.

High-Volume Arthroplasty Centers Demonstrate Higher Composite Quality Scores and Enhanced Value: Perspective on Higher-Volume Hospitals Performing Arthroplasty from 2001 to 2011.

Background: In recent years, there has been a move toward value-based health care. Value is generally defined as outcome divided by cost; however, it is not clear exactly how to define and measure outcomes. In this study, we utilized the Nationwide Inpatient Sample (NIS) to determine how hospital volume and other factors affect quality for patients undergoing total hip and knee arthroplasty.

Risk factors for Staphylococcus aureus colonization in a presurgical orthopedic population.

Background: Preoperative colonization with Staphylococcus aureus (SA) increases risk of surgical site infection. Screening for SA followed by skin and nasal decolonization can help to reduce the risk of postoperative infections. Risk factors for colonization are, however, not completely understood.

Disinfection of Blood Pressure Cuffs and Electrocardiographic Telemetry Leads With 0.5% Hydrogen Peroxide Wipes.

Background: Disinfection of frequently touched surfaces in the hospital is critical for providing safe care. Because of their complex intricate surfaces, blood pressure cuffs and electrocardiographic telemetry leads may be harder than other equipment to disinfect.

Objective: To determine the effectiveness of 0.

Door openings in the operating room are associated with increased environmental contamination.

Door openings in the operating room (OR) have been hypothesized to increase OR environmental contamination. This study measured average colony-forming units (CFU) in the OR as a function of door openings and other potentially important variables. Bacterial settle plates were placed inside and outside of laminar airflow (LAF) by both exit doors, on the instrument table, and on the back instrument table (if applicable) for 48 orthopedic and general surgery procedures.