Arthroplasty Today最新文献

{"title":"Total Hip Arthroplasty for Giant Hip Synovial Chondromatosis With Acetabular Involvement Complicated by Osteoarthritis: A 12-Year Follow-Up of a Case and Literature Review","authors":"Yu-zhou Shi MS,&nbsp;Ming-rui Xie MS,&nbsp;Bo Shi MS","doi":"10.1016/j.artd.2026.102101","DOIUrl":"10.1016/j.artd.2026.102101","url":null,"abstract":"<div><div>Synovial chondromatosis (SC) is a rare benign synovial disorder. Giant hip SC with acetabular involvement in the setting of end-stage osteoarthritis remains exceptionally uncommon, with limited long-term evidence available. We report a 50-year-old woman with giant SC of the left hip and acetabular invasion (Kellgren–Lawrence grade IV osteoarthritis), treated with cementless total hip arthroplasty via the Moore posterior approach combined with lesion resection and synovectomy. At 12-year follow-up, the patient achieved a Harris Hip Score of 98, with complete pain relief, stable prosthesis fixation, and no recurrence or malignant transformation. In addition, a literature review of 203 reported hip SC cases (2018-2024) demonstrated recurrence and revision rates of 10.34% and 22.58%, respectively, following total hip arthroplasty. No previously reported cases described giant SC with acetabular involvement.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"40 ","pages":"Article 102101"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148636103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Failure After Two-Stage Revision for Periprosthetic Joint Infections of the Knee","authors":"Praharsha Mulpur DNB (Ortho),&nbsp;Tarun Jayakumar MS (Ortho),&nbsp;Kikkuri Rajeev Reddy MS (Ortho),&nbsp;Karthik S.J. MS (Ortho),&nbsp;Kushal Hippalgaonkar DNB (Ortho),&nbsp;A.V. Gurava Reddy D.(Ortho), DNB (Ortho), MCh (Ortho), FRCS","doi":"10.1016/j.artd.2026.102104","DOIUrl":"10.1016/j.artd.2026.102104","url":null,"abstract":"<div><h3>Background</h3><div>Prosthetic joint infection (PJI) following total knee arthroplasty remains a serious complication. Although two-stage revision is considered the gold standard, predictors of failure remain unclear. This study aimed to identify factors associated with failure after two-stage revision for knee PJI using conventional statistics with exploratory machine-learning validation.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted on 154 patients who underwent two-stage revision for knee PJI between 2018 and 2022 at a high-volume arthroplasty center. All patients completed a minimum 24-month follow-up (mean 36.3 ± 20.3 months). Treatment success and failure were defined using MSIS Tier-1 criteria. Independent predictors of failure were identified using multivariate logistic regression and Random Forest classification model.</div></div><div><h3>Results</h3><div>Most infections were late in onset (91.6%), and 68.2% were culture-positive. Difficult-to-treat (DTT) organisms were identified in 22.1% of cases and were associated with significantly worse postoperative WOMAC, KSS, and OKS outcomes (all <em>P</em> &lt; .001). Multivariate analysis identified DTT organisms (odds ratio 0.035, <em>P</em> &lt; .001) and shorter time from index surgery to infection (odds ratio 1.033, <em>P</em> = .016) as independent predictors of failure. The random Forest model demonstrated an overall accuracy of 84.2% and identified DTT organisms, pre-revision C-reactive protein levels, and time from index surgery as the most influential variables contributing to classification performance. Most failures occurred within 30 months of reimplantation.</div></div><div><h3>Conclusions</h3><div>DTT organisms and shorter time from index surgery to infection were independent predictors of failure following two-stage revision for knee PJI. Exploratory machine-learning analysis identified similar predictor patterns and supports the importance of microbiological factors in determining outcomes.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"40 ","pages":"Article 102104"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148636104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peg Shearing as a Method of Failure in Highly Cross-Linked Polyethylene Patellar Components Used in Patellofemoral Arthroplasty","authors":"Morgan Pierce BA,&nbsp;Justin Leal MD,&nbsp;Fredrick Baker Mills MD,&nbsp;Jason Shah MD,&nbsp;Michael P. Bolognesi MD,&nbsp;William A. Jiranek MD","doi":"10.1016/j.artd.2026.102112","DOIUrl":"10.1016/j.artd.2026.102112","url":null,"abstract":"<div><div>Highly cross-linked polyethylene (HXLPE) is commonly used in knee arthroplasty due to its improved wear resistance. However, increased crosslinking reduces the tensile strength and fatigue resistance of polyethylene, which may be detrimental in high shear environments such as a cemented patellar button. In patellofemoral arthroplasty (PFA), patellar components are exposed to substantial shear stresses, which may predispose polyethylene components to fatigue-related failure and peg shear. We report a case series of patellar component failures in PFA, including several HXLPE patellar buttons demonstrating peg fracture and loosening, as well as 1 ultra–high molecular weight polyethylene patellar button with a similar failure pattern. To our knowledge, these represent the first reported cases of HXLPE patellar component peg shear in PFA, a complication previously described only in the setting of total knee arthroplasty.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"40 ","pages":"Article 102112"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148737426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subcuticular Sutures Outperform Staples in Early Wound Healing After Minimally Invasive Anterolateral Total Hip Arthroplasty","authors":"Thomas Stumpner MD,&nbsp;Jakob Wallner,&nbsp;Martin Bischofreiter MD, MSc,&nbsp;Michael S. Gruber MD,&nbsp;Harald Kindermann PhD,&nbsp;Reinhold Ortmaier MD, PhD","doi":"10.1016/j.artd.2026.102099","DOIUrl":"10.1016/j.artd.2026.102099","url":null,"abstract":"<div><h3>Background</h3><div>Wound complications remain a major concern after total hip arthroplasty (THA), as they delay mobilization, prolong hospitalization, and increase infection risk. Evidence on wound closure for the minimally invasive anterolateral approach is limited. Therefore, this study compared skin stapling and subcuticular suture closure regarding early wound healing and scar quality after minimally invasive anterolateral THA.</div></div><div><h3>Methods</h3><div>A total of 583 consecutive patients undergoing short-stem THA via minimally invasive anterolateral approach were retrospectively analyzed. All procedures used identical implants, perioperative protocols, and wound management. Procedures differed only in skin closure, using either staples or absorbable subcuticular sutures. Primary outcome was early wound condition, defined by secretion, erythema, and time until the wound was considered unremarkable. Secondary outcomes included revision for wound complications, early implant revision, length of hospital stay, and scar quality.</div></div><div><h3>Results</h3><div>Use of subcuticular sutures resulted in a significantly shorter duration of erythema (<em>P</em> = .049), earlier achievement of a bland wound (<em>P</em> &lt; .001), and a lower rate of prolonged wound secretion (≥7 days) than staples (0.69% vs 3.73%; <em>P</em> = .021; Odds Ratio (OR) 5.54). Hospital stay was shorter after sutures (6.1 ± 2.0 vs 7.0 ± 3.3 days; <em>P</em> &lt; .001). Rates of wound revision and early implant revision tended to be lower in the suture group, without statistical significance. Scar quality was comparable between groups.</div></div><div><h3>Conclusions</h3><div>Subcuticular suture closure was associated with improved early wound healing and earlier hospital discharge after minimally invasive anterolateral THA. These findings suggest a potential advantage which should be further evaluated in prospective randomized trials.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"40 ","pages":"Article 102099"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148737429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Summer Wind-up","authors":"Brett R. Levine MD, MS (Editor-in-Chief)","doi":"10.1016/j.artd.2026.102154","DOIUrl":"10.1016/j.artd.2026.102154","url":null,"abstract":"","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"40 ","pages":"Article 102154"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148951059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behavioral and Engagement Predictors of Arthroplasty Clinic No-Shows: A Calibrated Machine Learning Analysis","authors":"Rashed Alananzeh BA,&nbsp;Kameel Khabaz BA,&nbsp;Timothy Liu MD,&nbsp;Nicole J. Newman-Hung MD,&nbsp;Alexandra I. Stavrakis MD,&nbsp;Lauren E. Wessel MD","doi":"10.1016/j.artd.2026.102096","DOIUrl":"10.1016/j.artd.2026.102096","url":null,"abstract":"<div><h3>Background</h3><div>Missed clinic visits in arthroplasty care can impair preoperative optimization, delay surgery, and disrupt follow-up. Drivers of arthroplasty-specific no-shows remain incompletely characterized.</div></div><div><h3>Methods</h3><div>We extracted 94,723 scheduled arthroplasty appointments at a single tertiary academic center (March 2013–May 2025), retaining each patient's most recent encounter (N = 17,614) for primary analyses. Demographic, socioeconomic, clinical, scheduling, and prior-attendance variables were drawn from the electronic health record. Multivariable logistic regression and isotonic-calibrated machine learning models estimated no-show risk. Discrimination, calibration, and classification were assessed at multiple operating thresholds, and feature contributions were examined via Shapley Additive exPlanations.</div></div><div><h3>Results</h3><div>The no-show rate was 6.9%. Prior attendance behavior was the strongest predictor: each 10-percentage-point increase in historical no-show proportion conferred ∼26% higher odds (adjusted odds ratio [aOR]: 1.26 per 10 pp; full-range aOR: 9.86; 95% confidence interval: 6.16–15.76; <em>P</em> &lt; .001), and appointment confirmation was strongly protective (aOR: 0.24; 95% confidence interval: 0.19–0.29; <em>P</em> &lt; .001). Arthroplasty-relevant diagnoses such as osteoarthritis were associated with lower odds, while social determinants of health showed modest but persistent associations with increased risk. Calibrated machine-learning models achieved good discrimination (area under the receiver operating characteristic curve: 0.80) and calibration (Brier skill +0.12); at a capacity-matched threshold flagging the highest-risk 20%, the best-performing model captured ∼60% of no-shows with 82% specificity. Shapley Additive exPlanations highlighted prior no-show history and confirmation as dominant features.</div></div><div><h3>Conclusions</h3><div>Arthroplasty clinic no-shows reflects engagement patterns, administrative processes, and patient context. Calibrated, interpretable machine-learning models capturing ∼60% of no-shows within the highest-risk 20% of encounters support prospective evaluation for targeted, supportive outreach with equity safeguards.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"40 ","pages":"Article 102096"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148737422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved Pain and Function, Low Complication Rates, and 95% Patient Satisfaction at 2 Years After Medially Stabilized Total Knee Arthroplasty: A Prospective Multicenter Cohort Study","authors":"J. Baré MBBS, FRACS,&nbsp;L. Bradley MBChB, FRACS,&nbsp;R. Brighton MB, BS, FRACS,&nbsp;S. Talbot MBChB, FRACS,&nbsp;D. Wood MBChB, MRCS, FRCS","doi":"10.1016/j.artd.2026.102051","DOIUrl":"10.1016/j.artd.2026.102051","url":null,"abstract":"<div><h3>Background</h3><div>The medially stabilized (MS) knee concept has gained wider acceptance in recent years. However, to date, there is inconsistent evidence for its merits over traditional total knee arthroplasty (TKA) designs. The aim of this study was to assess the clinical performance of a second-generation medially stabilized knee obtainable by multiple, independent surgeons in a general TKA population.</div></div><div><h3>Methods</h3><div>Fifteen surgeons (16 hospitals) participated in this prospective nonrandomized cohort study of 568 patients (608 knees). Demographics represented a standard primary TKA population. Data were collected for baseline characteristics and outcome measures at 6, 12, and 24 months postoperatively for range of motion, the Knee injury and Osteoarthritis Outcome Score, Oxford Knee Score, EuroQol 5-Dimension visual analog scale, University of California Los Angeles activity score, Forgotten Joint Score, patient satisfaction scores, and complications.</div></div><div><h3>Results</h3><div>Overall, 548 TKAs were included in the final 2-year follow-up (90.8% follow-up). The revision rate at 2 years was 0.99% (6 knees revised). All measures reported significant improvement from preoperative to 24 months (<em>P</em> &lt; .0001), with good range of motion (119°) and high mean scores, including Oxford Knee Score 42 and Forgotten Joint Score 70. At 2 years, the median satisfaction score was 9.3, 95.7% of patients reported that their problems were better and 94.5% of patients responding that the results of their operation were good, very good, or excellent.</div></div><div><h3>Conclusions</h3><div>We found that use of a second-generation MS knee design by multiple surgeons can produce excellent outcomes, with low complication rates and higher levels of patient satisfaction, than those reported in the literature for traditional TKAs. This study represents the largest cohort, multisurgeon, prospective study reported in the literature for the introduction of a new generation MS TKA and supports its wider adoption.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"40 ","pages":"Article 102051"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148738120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aseptic Failure of Tibial Components With Sleeves in Revision Total Knee Arthroplasty: A Novel Radiographic Assessment of Zonal Fixation","authors":"Eric L. Colomb MD,&nbsp;Trey C. Rogers BS,&nbsp;Barrett B. Torre MD,&nbsp;Alex R. Orem MD, MS,&nbsp;Michael B. Sparks MD,&nbsp;Wayne E. Moschetti MD, MS","doi":"10.1016/j.artd.2026.102103","DOIUrl":"10.1016/j.artd.2026.102103","url":null,"abstract":"<div><h3>Background</h3><div>Aseptic sleeve failure in revision total knee arthroplasty (TKA) is rare, and associated risk factors remain poorly understood. Shortcomings exist with current methods for assessing stem fill. We hypothesize that inadequate medial base plate support and undersized stems contribute to aseptic loosening and varus collapse of tibial components with sleeves.</div></div><div><h3>Methods</h3><div>This retrospective review evaluated TKA cases revised for aseptic loosening of tibial sleeves at a single academic center from 2011 to 2024. Stem-to-endosteal canal fill ratios of knee radiographs were measured using the Parsley method, with adequate fill defined &gt;0.85. A novel area fill ratio was calculated along the sleeve and stem length using ImageJ software comparing implant area to total available area within the tibia. Medial base plate support was considered “unsupported” with gapping underneath the base plate &gt;2 mm or with an excessive cement mantle.</div></div><div><h3>Results</h3><div>Eighteen patients were revised for aseptic loosening of tibial components with sleeves, the majority (55.6%) demonstrating an unsupported medial base plate. Diaphyseal stem AP and lateral fill ratios using traditional Parsley method were undersized at 0.81 ± 0.13 (avg ± SD) and 0.77 ± 0.14, respectively. Using the area fill ratio method, the AP and lateral diaphyseal stems were more undersized measuring 0.74 ± 0.1 and 0.68 ± 0.11, respectively. Sleeve AP and lateral area fill ratios were 0.55 ± 0.1 and 0.51 ± 0.07.</div></div><div><h3>Conclusions</h3><div>Unsupported medial base plates and undersized tibial stems may contribute to aseptic loosening in revision TKA with sleeves. Current stem fill assessments have limitations, whereas the stem and sleeve area fill ratio represents a novel technique for comprehensive measurement of implant-to-endosteal contact.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"40 ","pages":"Article 102103"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148635971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microbiologic Patterns Found in Periprosthetic Joint Infections Following Total Joint Arthroplasty Differ Across Race and Sex","authors":"Pranit Kumaran BS,&nbsp;Julian Wier MD,&nbsp;Sahil S. Telang BS,&nbsp;Natalie M. Kistler BS,&nbsp;Jay R. Lieberman MD,&nbsp;Nathanael D. Heckmann MD","doi":"10.1016/j.artd.2026.102116","DOIUrl":"10.1016/j.artd.2026.102116","url":null,"abstract":"<div><h3>Background</h3><div>Despite extensive evidence demonstrating race- and sex-based disparities in periprosthetic joint infection (PJI) incidence following total joint arthroplasty, there is a lack of evidence on differences in the microbial profiles of pathogens identified. Our study evaluated the race- and sex-based differential microbial patterns of infecting organisms among patients with PJI.</div></div><div><h3>Methods</h3><div>The Premier Healthcare Database was queried from 2016 to 2023 for patients aged ≥18 years who underwent antibiotic spacer placement for a total joint arthroplasty PJI. Microbiology data were extracted from synovial and tissue cultures obtained during the hospital admission. Microbiological profiles were compared with respect to patient race via multivariable logistic regression. Race–sex subanalysis was then conducted via chi-squared testing.</div></div><div><h3>Results</h3><div>In total, 9014 patients were identified with 8189 (90.8%) White and 825 (9.2%) Black patients. Black patients had significantly higher adjusted odds of infection by methicillin-resistant <em>Staphylococcus aureus</em> (MRSA) (aOR: 1.45, [1.18-1.79], <em>P</em> &lt; .001) and gram-negative enterics (aOR: 1.45, [1.15-1.85], <em>P</em> = .01). Furthermore, Black males had the highest rates of MRSA infection (15.1%), while Black females had the highest rates of polymicrobial infections (24.3%).</div></div><div><h3>Conclusions</h3><div>Black patients had significantly greater risk of MRSA and gram-negative PJIs. Black males had the highest rates of MRSA and gram-negative enteric infection, while Black females exhibited the highest rates of polymicrobial infections. Further research into broader socioeconomic and health access disparities is warranted to explain the observed differences.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"40 ","pages":"Article 102116"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148737354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Dexamethasone Is Associated With a Reduced Risk of Periprosthetic Joint Infection Following Aseptic Revision Total Hip and Knee Arthroplasty","authors":"Sahil S. Telang BS,&nbsp;Pranit Kumaran BS,&nbsp;Sagar Telang MD,&nbsp;Ian A. Jones MD,&nbsp;Julian Wier MD,&nbsp;Andrew G. Yun MD,&nbsp;Jay R. Lieberman MD,&nbsp;Nathanael D. Heckmann MD","doi":"10.1016/j.artd.2026.102100","DOIUrl":"10.1016/j.artd.2026.102100","url":null,"abstract":"<div><h3>Background</h3><div>Dexamethasone has been increasingly used perioperatively for arthroplasty procedures. However, there is limited evidence on its use and safety for revision total hip (THA) and knee arthroplasty (TKA). This study sought to assess the association between perioperative dexamethasone administration and postoperative infectious complications in patients undergoing aseptic revision THA and TKA.</div></div><div><h3>Methods</h3><div>Using a national healthcare database, we identified adult patients undergoing aseptic, both-component revision THA and TKA between 2016 and 2023. Patients were stratified into those treated by high- (DEX[+]) or low-use (DEX[−]) dexamethasone surgeons using k-means clustering. Mixed-effects logistic regression was used to compare the 90-day rates of periprosthetic joint infection (PJI) and composite infectious outcomes between the DEX(+) and DEX(−) cohorts.</div></div><div><h3>Results</h3><div>In total, 35,222 patients were identified who underwent aseptic revision THA (n = 12,771) and TKA (n = 22,451). When accounting for surgeon clustering and comorbidities, DEX(+) demonstrated lower odds of PJI in revision THA (1.05% vs 3.42%, adjusted odds ratio [aOR]: 0.72, 95% confidence interval [CI]: 0.53-0.978, <em>P</em> = .035) and revision TKA (0.74% vs 2.87%, aOR: 0.75, 95% CI: 0.56-0.99, <em>P</em> = .042) as well as composite infectious outcomes in the revision THA (2.60% vs 12.15%, aOR: 0.58, 95% CI: 0.48-0.71, <em>P</em> &lt; .001) and revision TKA (1.66% vs 6.90%, aOR: 0.68, 95% CI: 0.56-0.83, <em>P</em> &lt; .001) cohorts.</div></div><div><h3>Conclusions</h3><div>Perioperative dexamethasone use was associated with reduced PJI and infectious risk following aseptic revision THA and TKA, supporting the routine dexamethasone administration in revision arthroplasty procedures.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"40 ","pages":"Article 102100"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148635961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}