Erratum to 'The Limited Utility of Hemoglobin A1c as a Predictor for Periprosthetic Joint Infection Following Total Joint Arthroplasty: A Continuous Variable Analysis' [The Journal of Arthroplasty 40 (2025) 1836-1844].

Background: Patients who have poorly controlled diabetes mellitus are at increased risk of periprosthetic joint infection (PJI). Nevertheless, an optimal preoperative hemoglobin A1c (HbA1c) threshold has not been established. This study sought to identify preoperative HbA1c thresholds that were predictive of adverse outcomes for total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients.

Total Hip Arthroplasty Among Superobese Patients: Proceed With Caution.

Background: Morbid obesity, defined as body mass index (BMI) ≥40 kg/m, increases perioperative risk following total hip arthroplasty (THA). However, limited contemporary data exists on outcomes of superobese patients (BMI ≥50 kg/m) following primary THA. Using a large modern cohort, this study seeks to quantify the risk of infection and surgical, medical, and thromboembolic complications among superobese THA patients.

Electroreception in treehoppers: How extreme morphologies can increase electrical sensitivity.

The link between form and function of an organism's morphology is usually apparent or intuitive. However, some clades of organisms show remarkable diversity in their form, often exhibiting extreme morphologies, but with no obvious functional explanation. Treehoppers (Membracidae) are a family of insects that exemplify this, displaying an astounding morphological diversity, resulting in a plethora of extreme forms.

Vulnerability of tropical fish communities across depth in the central Indian Ocean.

Coral reefs and their fish communities below scuba diving depth (>30 m), in mesophotic coral ecosystems (MCEs) (∼30-150 m), in rariphotic (150-300 m), and in upper bathyal waters (300-500 m) are often underexplored, especially in the Indian Ocean. The paucity of data, including on the biodiversity, ecology, and vulnerability of these habitats and the communities they support, leads to their omission from most conservation and management decisions and practices. We investigated for the first time the structure and diversity (taxonomic and functional) of demersal fish communities from the central and southern atolls of the Maldives, spanning a wide bathymetric gradient of 2-500 m to better understand whether and how their vulnerability changes across depth.

Medicare Reimbursement for Primary Hip and Knee Arthroplasty Is Disproportionately Decreasing Relative to Other High-Volume Inpatient Procedures: Leader of the Pack.

Background: Decreasing Medicare surgeon reimbursement for total hip arthroplasty (THA) and total knee arthroplasty (TKA) may limit access to care. The purpose of this study was to examine trends in Medicare reimbursement fees for primary THA and TKA and compare reimbursement to other high-volume nonarthroplasty procedures.

Methods: A nationally representative database was retrospectively queried to identify the most frequently performed inpatient procedures in the United States from 2016 to 2020.

Low-Level Evidence Used to Substantiate Insurance Coverage Policies for Knee and Hip Arthroplasty.

Background: Access to total knee arthroplasty (TKA) or total hip arthroplasty (THA) has become increasingly regulated by health care insurance providers that require specific criteria be met prior to authorizing surgery as medically necessary. The purpose of this study was to examine references from coverage policies and assess whether they justify the presurgery criteria mandated by insurance providers for approval of total joint arthroplasty in patients who have symptomatic knee and hip degenerative disease.

Methods: The largest private commercial insurance providers in the United States were identified, of which nine had publicly accessible coverage policies for TKA and THA.

Rivaroxaban Utilization Without Perioperative Tranexamic Acid Is Associated With an Increased Risk of Bleeding Complications Following Total Joint Arthroplasty.

Background: Rivaroxaban provides effective venous thromboembolic prophylaxis, but there are concerns about associated bleeding in total joint arthroplasty (TJA) patients. This study aimed to investigate whether the perioperative administration of tranexamic acid (TXA) in TJA patients receiving rivaroxaban for thromboprophylaxis is associated with a reduced risk of postoperative bleeding complications.

Methods: A healthcare database was utilized to identify all primary total knee arthroplasty (TKA) and total hip arthroplasty (THA) patients between 2015 and 2021.

Effect of BMI on the risk of postoperative complications following total hip arthroplasty.

Aims: While obesity is associated with an increased risk of complications after total hip arthroplasty (THA), the relationship between BMI and the risk of early postoperative complications has not been fully characterized. This study sought to describe the relationship between BMI and the risk of early postoperative complications, including periprosthetic joint infection (PJI), and composite surgical and composite medical complications.

Methods: Primary, elective THAs performed from 1 October 2015 to 31 December 2021 were identified using the Premier Healthcare Database.

Medicare Reimbursement for Primary and Revision Total Hip and Knee Arthroplasty: An Updated Analysis From 2000 to 2024.

Background: With physician reimbursements for primary and revision total hip (THA) and knee arthroplasty (TKA) remaining central to health care policy and payment reforms, an updated analysis of inflation-adjusted Medicare surgeon fees for these procedures is essential. Examining recent payment trends offers valuable insights for surgeons, payers, and health care policymakers to understand the evolving reimbursement landscape. This study aimed to analyze physician reimbursement trends for THA and TKA from 2000 to 2024.

Preoperative Anemia as a Predictor of Periprosthetic Joint Infection Following Total Knee Arthroplasty: A Continuous Variable Analysis.

Background: Preoperative anemia, defined by the World Health Organization as hemoglobin levels below 12.0 g/dL in women and below 13.0 g/dL in men, has been associated with postoperative complications following total knee arthroplasty (TKA).

Evolving Role of Lumbar Decompression: A Narrative Review.

Traditional open lumbar decompression techniques have long been used to relieve spinal canal pressure caused by lumbar spinal stenosis. However, these procedures are associated with significant postoperative pain and prolonged recovery. Over the past few decades, there has been a shift toward minimally invasive surgical (MIS) techniques designed to minimize tissue trauma, postoperative pain, and recovery time.

Albumin as a Predictor of Periprosthetic Joint Infection Following Total Joint Arthroplasty: Identifying a New Data-Driven Threshold Utilizing a Continuous Variable Analysis.

Background: Albumin is a preoperative risk stratification tool for patients undergoing primary total knee arthroplasty (TKA) and total hip arthroplasty (THA). However, existing literature predominantly evaluates serum albumin levels as a categorical variable using predetermined cut-off values, limiting our ability to identify a data-driven risk threshold. Our study addresses this gap by analyzing albumin as a continuous variable, aiming to establish a more clinically relevant preoperative threshold for identifying patients at increased risk of postoperative complications.

The Limited Utility of Hemoglobin A1c as a Predictor for Periprosthetic Joint Infection Following Total Joint Arthroplasty: A Continuous Variable Analysis.

Background: Patients who have poorly controlled diabetes mellitus are at increased risk of periprosthetic joint infection (PJI). Nevertheless, an optimal preoperative hemoglobin A1c (HbA1c) threshold has not been established. This study sought to identify preoperative HbA1c thresholds that were predictive of adverse outcomes for total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients.

Complete Blood Cell Count-Based Ratios Identify Total Joint Arthroplasty Patients Likely to Benefit from Perioperative Dexamethasone.

Background: Complete blood cell count-based ratios (CBRs), including the neutrophil-lymphocyte ratio (NLR) and monocyte-lymphocyte ratio (MLR), are inflammatory markers associated with postoperative morbidity. Given the link between the surgical stress response and complications after total joint arthroplasty (TJA), this study aimed to evaluate whether higher preoperative CBR values predict greater postoperative benefits associated with dexamethasone utilization.

Methods: The Premier Healthcare Database was queried for adult patients who underwent primary, elective total hip or knee arthroplasty (THA or TKA).

Tranexamic Acid Is Safe in Arthroplasty Patients Who Have a History of Venous Thromboembolism: An Analysis Accounting for Surgeon Selection Bias.

Background: Retrospective data supporting the use of tranexamic acid (TXA) among high-risk total joint arthroplasty (TJA) patients are 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 while accounting for surgeon selection.

Methods: A healthcare database was retrospectively queried from 2015 to 2021 to identify all patients who had a history of deep vein thrombosis or pulmonary embolism who underwent elective TJA.

Low-Volume Surgeons Operating at High-Volume Hospitals Have Low Rates of Periprosthetic Joint Infection After Hip and Knee Arthroplasty.

Background: The relationship between surgeon and hospital case volumes and postoperative risk following total hip arthroplasty and total knee arthroplasty (THA and TKA) has been described independently. This study aimed to assess the risk of periprosthetic joint infection (PJI) following primary TKA and THA to determine if lower volume surgeons operating at higher volume centers would have lower rates of complications compared to lower volume surgeons operating at lower volume hospitals.

Methods: A health care database was used to retrospectively identify all primary and elective total joint arthroplasties from October 2015 to December 2021.

Dual-Mobility Articulations in Primary Total Hip Arthroplasty: Mid-Term Outcomes From the American Joint Replacement Registry.

Background: In recent years, there has been an increased utilization of dual-mobility (DM) implants in primary total hip arthroplasty (THA) to mitigate the risk of postoperative hip instability. This study aimed to present mid-term outcomes of DM bearings in primary THA using data from the American Joint Replacement Registry.

Methods: Screening was conducted on patients aged ≥ 65 years who underwent primary THA between 2012 and 2018.

Enhancing African coelacanth monitoring using environmental DNA.

Coelacanths are rare, elusive, ancient lobe-finned fish species, residing in poorly accessible tropical marine caves and requiring close monitoring and protection. Environmental DNA (eDNA) approaches are being increasingly applied in the detection of rare and threatened species. Here we devise an eDNA approach to detect the presence of African coelacanths () off the eastern coast of South Africa.

Body Mass Index and the Risk of Postoperative Complications After Total Knee Arthroplasty.

Introduction: Given the growing prevalence of obesity, it is crucial to understand the effect of obesity on complications after total knee arthroplasty (TKA). This study aims to assess the relationship between body mass index (BMI) and postoperative periprosthetic joint infection (PJI), medical complications, and surgical complications after TKA.

Methods: The Premier Healthcare Database was used to identify all primary elective TKAs between 2016 and 2021.

Perioperative Systemic Corticosteroids in Modern Total Hip and Knee Arthroplasty: A Primer for Clinical Practice.

» Perioperative corticosteroids are strongly recommended for reducing the incidence and severity of postoperative nausea and vomiting following elective total hip or total knee arthroplasty.» Corticosteroids may reduce postoperative pain and opioid requirements. Similarly, corticosteroids appear to have a neutral-to-positive effect on length of stay, venous thromboembolism, mobility, delirium, acute kidney injury, and bone cement implantation syndrome (i.

Glucagon-Like Peptide Receptor-1 Agonists Used for Medically-Supervised Weight Loss in Patients With Hip and Knee Osteoarthritis: Critical Considerations for the Arthroplasty Surgeon.

Patients with morbid obesity and concomitant hip or knee osteoarthritis represent a challenging patient demographic to treat as these patients often present earlier in life, have more severe symptoms, and have worse surgical outcomes following total hip and total knee arthroplasty. Previously, bariatric and metabolic surgeries represented one of the few weight loss interventions that morbidly obese patients could undergo prior to total joint arthroplasty. However, data regarding the reduction in complications with preoperative bariatric surgery remain mixed.

Preoperative Laboratory Values Predicting Periprosthetic Joint Infection in Morbidly Obese Patients Undergoing Total Hip or Knee Arthroplasty.

Background: Morbidly obese patients are an ever-growing high-risk population undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA) for end-stage osteoarthritis. This study sought to identify preoperative laboratory values that may serve as predictors of periprosthetic joint infection (PJI) in morbidly obese patients undergoing THA or TKA.

Methods: All morbidly obese patients with preoperative laboratory data before undergoing primary elective TKA or THA were identified using the Premier Healthcare Database.

Super-Obesity is Associated With an Increased Risk of Complications Following Primary Total Knee Arthroplasty.

Background: Obesity, defined as a body mass index (BMI) ≥ 30, is an ever-growing epidemic, with > 35% of adults in the United States currently classified as obese. Super-obese individuals, defined as those who have a BMI ≥ 50, are the fastest-growing portion of this group. This study sought to quantify the infection risk as well as the incidence of surgical, medical, and thromboembolic complications among super-obese patients undergoing total knee arthroplasty (TKA).