Venous thromboembolism (VTE) prophylaxis after total joint arthroplasty is considered best practice. However, over the past 5 years, there has been considerable debate about the ideal prophylactic regimen or modality. The American Academy of Orthopaedic Surgeons and the American College of Chest Physicians published their most recent clinical practice guidelines about VTE prophylaxis in 2011 an...

Total Joint Arthroplasty (TJA) has proven to be very successful in the treatment of patients suffering from endstage osteoarthritis of the hip and knee [1,2]. The demand for primary TJAs is expected to dramatically increase over the next several years due to more procedures being performed annually, younger patients being considered candidates for surgery, and patients exhibiting longer life ex...

The Center for Disease Control and Prevention recently released their 2017 Guideline for the Prevention of Surgical Site Infection. One of their recommendations is the ordering of a single dose of preoperative prophylactic antibiotics with no subsequent postoperative dosing; this recommendation includes perioperative antibiotics for patients undergoing total joint arthroplasty. At this time, th...

Turn on the television, radio, or open your favorite newspaper or online newsfeed and you will undoubtedly come across stories on health care economics and policy. Similarly, pick up a medical journal and there is a good chance that youwill come across studies on some aspect of health care economics. The recent change in the White House administration has only kept the topic of health care deli...

Adequate postoperative pain control in patients who have undergone total joint arthroplasty allows faster rehabilitation and reduces the rate of postoperative complications. Multimodal pain management involves the introduction of adjunctive pain control methods in an attempt to control pain with less reliance on opioids and fewer side effects. Current research suggests that traditional nonstero...

BACKGROUND Improving access to total joint replacement (TJR) has been a priority. Without robust mechanisms to ensure appropriateness, these procedures may be overused, incurring substantial costs. In that context, decision-makers are particularly concerned with the appropriateness of TJR. OBJECTIVE While our previous research focused on the appropriateness of TJR from clinical and patient pe...

Total Joint Arthroplasty (TJA) is one of the most common orthopaedic procedures performed worldwide that restores function and allows patients to maintain their activities of daily living [1] Optimizing patients for surgery is of utmost importance, including conserving blood to minimize the risk of surgical site infection since immunomodulatory effects of allogenic blood [2] predisposes TJA pat...

The authors report a simple technique for effective management of surgical drains and their reliable removal in elective hip and knee arthroplasty. Many surgeons use surgical drains for elective total hip and knee arthroplasties and instruct residents in their use despite limited evidence to support routine use of surgical drains in noninfected cases. There are many different types of drains an...

Optimal perioperative pain control for total joint arthroplasty remains a challenge. Whereas traditional regimens have relied heavily on opioids, newer multimodal pathways are increasingly gaining popularity as safer and more effective alternatives. The main premise of multimodal analgesia is decreased consumption of opioids, and hence lesser opioid-related adverse events. Other reported advant...