Safety of Perioperative Cefazolin in Penicillin-Anaphylactic Patients for Total Hip and Knee Arthroplasty.

Background: Cefazolin, a first-generation cephalosporin, is the preferred antibiotic for prophylaxis in elective primary total hip and knee arthroplasties (THAs and TKAs). While most of its chemical structure differs from penicillin (PCN), its shared beta-lactam ring has historically raised concerns about cross-reactivity in patients who have with reported PCN allergies. However, studies suggest that patients who report a PCN allergy have a 50% increased odds of surgical site infection, often due to receiving second-line perioperative antibiotics.

Intraoperative Irrigation and Topical Antibiotic Use Fail to Reduce Early Periprosthetic Joint Infection Rates: A Michigan Arthroplasty Registry Collaborative Quality Initiative Study.

Background: Periprosthetic joint infections remain a major complication in total joint arthroplasty. Tremendous efforts made intraoperatively to prevent periprosthetic joint infection during primary procedures include antiseptics or antibiotics in irrigation solutions. This study analyzed the incidence of postoperative infection in relation to use of irrigation solutions and antibiotic powder.

Association Between Initial Prescription Size and Likelihood of Opioid Refill After Total Knee and Hip Arthroplasty.

Background: The present study was designed to test the hypothesis that there was no association between initial opioid prescription size and the likelihood of refill after elective primary total knee (TKA) and hip arthroplasty (THA).

Methods: We retrospectively analyzed large national datasets of commercial and Medicare insurance claims to identify a weighted cohort of 120,889 primary total joint arthroplasties (76,900 TKA and 43,989 THA) comprised of opioid-naive patients aged 18 to 75 years who had surgery between January 2015 and November 2019. The primary outcome was refill of any prescription opioid medication within 30 days after discharge, and the primary predictor variable was the total amount of opioid filled in the initial discharge prescription measured in oral morphine equivalents (OMEs).

Risk factors for readmission of orthopaedic surgical patients.

Background: Reducing hospital readmissions has become a priority in the development of policies aimed at patient safety and cost reduction. Evaluating the incidence of rehospitalization of orthopaedic surgical patients could help to identify targets for more efficient perioperative care. We addressed two questions: What is the incidence of thirty-day readmission for orthopaedic patients at an academic hospital? Can any risk factors for readmission be identified among rehospitalized patients?

Methods: This is a retrospective cohort study examining 3264 orthopaedic surgical admissions during two fiscal years from the hospital's quality-improvement database.