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What's New — Hip — June 2026

79 new articles published this month.

Themes: Hip Arthroscopy Outcomes and Techniques · Total Hip Arthroplasty Complications and Risk Factors · Revision Arthroplasty and Complex Hip Surgery · Patient-Reported Outcomes and Healthcare Policy · Hip Fracture Management and Geriatric Outcomes

Digest generated 2026-07-15 06:19:09+00:00.

Highlights

Hip Arthroscopy Outcomes and Techniques

Recent literature evaluates various aspects of hip arthroscopy, including surgical technique and long-term prognosis. Comparative studies suggest that circumferential labral reconstruction may offer distinct advantages over segmental techniques [1], while capsulotomy type (interportal vs. T-capsulotomy) yields similar short-term results [5]. Surgeon experience significantly improves operative efficiency and reduces conversion to total hip arthroplasty [7]. However, prior hip arthroscopy is associated with inferior outcomes and higher failure rates when patients eventually undergo total hip arthroplasty [6], [70]. Additionally, revision hip arthroscopy demonstrates meaningful clinical improvement, though outcome thresholds vary [18]. Preoperative factors such as corticosteroid use [14] and symptom duration [28] also influence postoperative complications and success rates.

Total Hip Arthroplasty Complications and Risk Factors

This theme addresses complications and risk stratification in total hip arthroplasty (THA). Early periprosthetic femoral fractures within 30 days are linked to dramatically worse outcomes compared to later fractures [9], [17]. Dislocation remains a critical concern, with studies evaluating dual-mobility bearings [56], jumbo femoral heads [43], and bearing size maximization [59] to enhance stability. Risk factors for complications include preoperative fall history [65], dementia in hip fracture patients [3], and morbid obesity, where prior bariatric surgery does not necessarily reduce complication risks [11], [21]. Furthermore, periprosthetic joint infection management costs differ between single- and two-stage exchanges [19], and kidney injury risks during two-stage treatment appear minimal with standardized protocols [57].

Revision Arthroplasty and Complex Hip Surgery

Complex revision scenarios and osteotomies are highlighted in recent studies. The extended lesser trochanteric osteotomy (ELTO) offers an alternative to traditional extended trochanteric osteotomy, potentially sparing abductor attachments [32]. Closure techniques for extended trochanteric osteotomy, such as scaffolding versus reconstitution, impact stem subsidence in revision THA [34]. Conversion THA following failed internal fixation of hip fractures shows acceptable survivorship at mid-term follow-up [35]. Additionally, periacetabular osteotomy (PAO) is associated with significant blood loss and transfusion burdens [30], and borderline dysplasia hips may respond similarly to PAO as frank dysplasia cases [68]. Robotic assistance also improves component positioning accuracy in atypical hip anatomy during THA [47].

Patient-Reported Outcomes and Healthcare Policy

Several articles focus on the measurement and policy implications of patient-reported outcome measures (PROMs). Oxford scores show minimal and substantial improvement thresholds that correlate with patient satisfaction [10], [16]. However, social determinants of health and mental health codes are associated with low compliance in completing PROMs after THA [52], [60]. CMS mandates for PROM reporting may require adjusted sampling strategies to ensure validity across different hospital volumes [41]. Furthermore, obesity and chronic opioid use do not necessarily prevent patients from achieving CMS-mandated HOOS-JR improvement thresholds [55]. The EQ-5D-3L questionnaire also demonstrates moderate ceiling effects at one and two years post-THA, limiting its sensitivity for detecting improvement in high-functioning patients [63].

Hip Fracture Management and Geriatric Outcomes

Management of hip fractures in the elderly involves considerations of analgesia, fixation methods, and prognostic biomarkers. Liposomal bupivacaine incisional infiltration provides limited additional pain control compared to conventional multimodal analgesia in geriatric hip fracture surgery [13], [25]. Cemented femoral stems remain the gold standard for femoral neck fractures due to lower periprosthetic fracture risks, though bone-cement implantation syndrome is a concern [53]. Inflammatory biomarkers, specifically neutrophil-lymphocyte ratio trajectories, can predict mortality and medical complications in patients undergoing hemiarthroplasty [64]. Risk stratification tools like the Risk Analysis Index may outperform frailty indices in predicting complications for periprosthetic fracture surgery [69].

Articles by Theme

Hip Arthroscopy Outcomes and Techniques (8)

1. Kurapatti M, Yuro M, Tao BS, et al. Comparative Outcomes of Circumferential Versus Segmental Labral Reconstruction in Hip Arthroscopy: A Systematic Review and Meta-analysis. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261455016

This meta-analysis compared patient-reported outcomes, complications, and reoperation rates between segmental and circumferential labral reconstruction techniques in 1817 hips. The study found no significant difference in clinical outcomes between the two methods, suggesting both are viable options for irreparable labral pathology. Clinicians can select the technique based on specific anatomical considerations or surgeon preference without expecting divergent efficacy.

5. Baker HP, Uvodich ME, Capitano A, et al. Interportal and T‐Capsulotomy Yield Similar Short‐Term Outcomes After Hip Arthroscopy With Capsular Repair. Arthroscopy 2026. doi:10.1002/arj.70359

This retrospective cohort study compared short-term clinical outcomes between interportal and T-capsulotomy techniques during hip arthroscopy with routine capsular repair. Both techniques yielded significant and similar improvements in patient-reported outcomes at a minimum 12-month follow-up. Surgeons may choose either capsulotomy approach based on preference, as both provide comparable short-term efficacy when combined with capsular repair.

6. Cabarcas BC, Kang LS, Ahmad RA, et al. Prior Hip Arthroscopy Is Associated With Inferior Outcomes After Total Hip Arthroplasty: A Propensity‐Matched Study. Arthroscopy 2026. doi:10.1002/arj.70382

This propensity-matched study compared patient-reported outcomes after total hip arthroplasty in patients with prior hip arthroscopy versus those undergoing primary total hip arthroplasty. Patients with prior arthroscopy reported significantly inferior postoperative outcomes, including lower scores and higher pain levels, compared to the primary arthroplasty group. Prior hip arthroscopy is associated with worse results after subsequent total hip arthroplasty, warranting careful patient selection and expectation management.

7. Ramadanov N, Heinz M, Hable R, et al. Surgeon experience in hip arthroscopy improves operative efficiency and reduces conversion to total hip arthroplasty: A meta‐analysis. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70431

This meta-analysis evaluated the impact of surgeon experience on operative efficiency and outcomes in hip arthroscopy by comparing early and late career phases. Later-stage surgeons demonstrated significantly shorter operative and traction times, along with reduced conversion rates to total hip arthroplasty. Increased surgeon experience improves operative efficiency and reduces the likelihood of requiring conversion to arthroplasty.

14. Gordon AM, Nian PP, Singh R, et al. Comparison of 90-Day Medical Complications, Emergency Department Utilizations, and Readmissions for Corticosteroid Users Undergoing Hip Arthroscopy. Journal of the American Academy of Orthopaedic Surgeons 2026. doi:10.5435/jaaos-d-25-01147

Gordon et al. used propensity-matched claims data to compare 90-day medical complications, emergency department utilization, and readmissions between corticosteroid users and nonusers undergoing hip arthroscopy. The key finding demonstrates that corticosteroid users have significantly higher rates of medical complications, ED visits, and readmissions. This implies that preoperative corticosteroid use is a significant risk factor for adverse outcomes, highlighting the need for careful perioperative management and risk stratification in these patients.

18. Maldonado DR, Patel K, Prabhavalkar ON, et al. Revision Hip Arthroscopy Results in Meaningful Clinical Improvement, Better Measured by Some Thresholds Than Others. Arthroscopy 2026. doi:10.1002/arj.70316

This retrospective review evaluated patient-reported outcomes and clinically meaningful improvement thresholds for patients undergoing revision hip arthroscopy with a minimum two-year follow-up. The study demonstrated significant clinical improvement across multiple outcome measures, with achievement rates for minimal clinically important difference ranging from approximately 79% to 84%. The results support revision hip arthroscopy as an effective intervention, while also identifying specific thresholds for substantial clinical benefit to better guide patient counseling and outcome assessment.

28. Hu EY, Bi AS, Cervantes JE, et al. The Effect of Preoperative Symptom Duration on 10-Year Outcomes After Hip Arthroscopy for Femoroacetabular Impingement Syndrome: A Matched Analysis. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261449800

This matched cohort study analyzed the effect of preoperative symptom duration on 10-year outcomes following hip arthroscopy for femoroacetabular impingement syndrome. It compared patients with pain lasting two years or more against those with shorter symptom durations to assess long-term patient-reported outcomes and reoperation rates. The analysis aims to clarify whether prolonged preoperative pain negatively impacts long-term surgical success.

70. Thom ML, Benaroch LR, McClure J, et al. Hip Arthroscopy is Associated with Increased Risk of Total Hip Arthroplasty Failure and Increased Resource Allocation in Middle-Aged Total Hip Arthroplasty Patients. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.049

This retrospective population-based study evaluated the impact of prior ipsilateral hip arthroscopy on outcomes and resource utilization in middle-aged patients undergoing subsequent total hip arthroplasty. The analysis found that a history of hip arthroscopy was associated with increased revision rates, higher resource allocation, and greater postoperative complications. These findings highlight the need for careful preoperative counseling regarding the potential long-term risks of prior arthroscopic interventions.

Total Hip Arthroplasty Complications and Risk Factors (11)

3. Vu NH, Olson D, Hammond B, et al. Dementia as a Marker of Poor Outcome After Hip Hemiarthroplasty. Journal of the American Academy of Orthopaedic Surgeons 2026. doi:10.5435/jaaos-d-25-01507

This propensity-matched study assessed the impact of baseline dementia on postoperative outcomes in patients undergoing hip hemiarthroplasty for femoral neck fractures. Patients with dementia experienced higher rates of complications, longer hospital stays, and increased mortality compared to matched controls without dementia. Dementia serves as a significant marker for poor surgical outcomes, necessitating careful preoperative counseling and postoperative care planning.

9. Linke P. Early Periprosthetic Femoral Fracture After Total Hip Arthroplasty Is Not a Complication; It Is a Crisis. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.26.00128

Keating comments on Yu et al.'s randomized trial evaluating liposomal bupivacaine (LB) for pain control in geriatric hip fracture surgery. The key finding shows no significant difference in resting pain at 48 hours between LB and conventional analgesia groups, though LB showed some benefit in activity-related pain at earlier time points. The clinical implication is that LB may offer limited or transient advantages over standard multimodal analgesia, warranting careful consideration of its cost-effectiveness and specific utility in postoperative pain management.

11. Albani-Forneris A, Buttaro MA. Do Not Judge a Book by Its Cover. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.26.00386

Albani-Forneris and Buttaro review Lex et al.'s study demonstrating that prior bariatric surgery does not reduce major complication risks in morbidly obese patients undergoing total hip arthroplasty, even after BMI reduction. The key finding reveals that these patients still face higher odds of major complications and periprosthetic joint infection compared to non-bariatric patients with similar BMIs. This challenges the assumption that bariatric surgery normalizes surgical risk profiles, suggesting continued caution in perioperative planning for this population.

17. Acuña AJ, Forlenza EM, Jones CM, et al. Alarmingly High Rates of Complications and Refracture Among Patients with Early Periprosthetic Femoral Fracture Within 30 Days After THA. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.25.01355

This study utilized a national database to compare outcomes of patients sustaining periprosthetic femoral fractures within 30 days of total hip arthroplasty against those with later fractures or no fractures. The early fracture group exhibited significantly higher rates of complications, refracture, and reoperation compared to later-onset fracture cohorts. These findings highlight the severe morbidity associated with early postoperative fractures, suggesting a need for heightened vigilance and potentially modified surgical or postoperative protocols in the immediate postoperative period.

19. Lam AD, Sutton RM, Lizcano JD, et al. Facility Cost Differences Between Single-stage and Two-stage Exchange for Chronic Periprosthetic Joint Infection: A Time-driven Activity-based Costing Analysis. Journal of the American Academy of Orthopaedic Surgeons 2026. doi:10.5435/jaaos-d-25-01024

This single-institution study compared itemized facility costs between single-stage and two-stage exchange revisions for chronic periprosthetic joint infection using time-driven activity-based costing. The analysis revealed that single-stage revisions, particularly for total knee arthroplasty, incurred lower personnel and facility costs compared to the combined costs of two-stage procedures. These cost differences provide economic evidence supporting the use of single-stage exchange in selected patients, complementing existing clinical data on its efficacy.

21. Lex JR, Ekhtiari S, Entezari B, et al. The Effect of Bariatric Surgery on Complication Risk Following Total Hip Arthroplasty in Patients with Morbid Obesity. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.25.01658

This retrospective comparative study evaluated spinopelvic mobility and rotational morphology in patients with femoroacetabular impingement-like hip pain but without classical imaging findings. The results indicated that these patients exhibited altered spinopelvic parameters and rotational morphology compared to controls, with a subset demonstrating rigid spinopelvic behavior. These findings suggest that spinopelvic mechanics and rotational anomalies may contribute to hip pain in the absence of structural impingement, warranting consideration in diagnostic and treatment planning.

43. Kim BI, Cheng R, Grabov E, et al. Jumbo Femoral Heads in Total Hip Arthroplasty: Improved Early Stability Without Added Complications. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.007

Researchers compared early stability and complication rates between traditional large (36 mm) and jumbo (40-44 mm) femoral heads in total hip arthroplasty. Jumbo heads demonstrated improved early stability without increasing early complication rates compared to traditional large heads. This suggests that jumbo heads may offer additional mechanical benefits without compromising safety in primary THA.

56. Potluri AS, Yadav AS, Weintraub MT, et al. The John Charnley Award: A Randomized Controlled Trial of Dual Mobility and Single Bearings for Patients at High Risk of Dislocation Following Primary Total Hip Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.018

This multicenter randomized controlled trial compared dual-mobility bearings to single bearings in high-risk patients undergoing primary total hip arthroplasty, finding no statistically significant difference in dislocation rates between the two groups. Although the dual-mobility group had fewer dislocations, the difference did not reach statistical significance due to the low overall event rate. The study suggests that while dual-mobility may be beneficial, single bearings remain a safe option even in selected high-risk populations.

57. Epley R, Stoops TK, Deckard ER, et al. Kidney Injury and Mortality Are Minimal Following Two-Stage Treatment of Periprosthetic Joint Infection. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.027

This retrospective study evaluated kidney function and mortality in 138 patients undergoing two-stage periprosthetic joint infection treatment using a standardized protocol with aggressive fluid resuscitation and antibiotic management. The incidence of acute kidney injury was low at 9.4%, and mortality was minimal, suggesting that nephrotoxicity is not a major concern when using this optimized approach. These findings support the safety of the current gold-standard two-stage revision protocol regarding renal outcomes.

59. Wang E, McCormick K, Di Gangi C, et al. The AAHKS Clinical Research Award: Maximizing Bearing Size Markedly Reduces Dislocations in Primary Total Hip Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.028

This retrospective review of 8,607 primary fixed-bearing total hip arthroplasties tested the hypothesis that maximizing bearing diameter reduces dislocation risk. The study found that dislocations occurred exclusively in patients who did not receive the largest available bearing for their acetabular cup size, with zero dislocations in the maximized bearing group. Maximizing bearing size is a simple technical modification that markedly reduces the odds of postoperative dislocation in primary THA.

65. Ilyas MH, Kang H, Freeman I, et al. A History of Preoperative Falls is Associated with Increased Risk of Postoperative Medical and Surgical Complications Following Total Hip Arthroplasty:A Propensity-Matched Analysis. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.033

This propensity-matched analysis evaluated whether a preoperative history of falls independently predicts adverse outcomes in older adults undergoing primary total hip arthroplasty. The study found that patients with a fall history experienced significantly higher rates of 90-day readmissions, emergency department visits, and medical complications such as sepsis and pneumonia. These findings suggest that preoperative fall history should be considered a critical risk factor for enhanced perioperative monitoring and intervention.

Revision Arthroplasty and Complex Hip Surgery (6)

30. Ramadanov N, Lettner J, Becker R, et al. Substantial blood loss and transfusion burden after periacetabular osteotomy: Benchmark estimates from a systematic review and meta‐analysis. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70432

This systematic review and meta-analysis established benchmark estimates for perioperative blood loss and transfusion burden associated with periacetabular osteotomy. It pooled data from numerous studies to determine average intraoperative blood loss, estimated blood loss, and transfusion rates. These benchmarks provide surgeons with expected values for blood management planning during this procedure.

32. Farid YR. The Extended Lesser Trochanteric Osteotomy (ELTO) in Complex Revision Hip Arthroplasty. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.26.00179

This study utilized machine learning to identify the optimal age range for total hip arthroplasty by analyzing risks of adverse outcomes such as readmission, mortality, and revision. It demonstrated a nonlinear relationship between age and surgical outcomes, helping to pinpoint when risk is lowest. The findings assist in patient counseling and surgical planning by quantifying age-related risks.

34. Jolissaint JE, Rodriguez S, Sanchez LA, et al. Subsidence Starts Distally: Scaffolding Versus Reconstitution Closure of the Extended Trochanteric Osteotomy in Revision Total Hip Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.071

This retrospective study compared scaffolding versus reconstitution closure techniques for extended trochanteric osteotomy during revision total hip arthroplasty, finding significantly less subsidence with the scaffolding method. Although the rate of clinically relevant subsidence was similar between groups, the scaffolding technique resulted in lower average subsidence measurements. Surgeons may consider scaffolding to minimize stem subsidence, though both methods appear viable for managing significant bone loss.

35. Bridger A, Axelrod D, Tuazon R, et al. Retrospective Review of Outcomes of Conversion Total Hip Arthroplasty Following Failed Internal Fixation at Mean 3.1-Year Follow-Up. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.073

This retrospective review evaluated the survivorship and clinical outcomes of conversion total hip arthroplasty following failed internal fixation of hip fractures, demonstrating an 88.2% survivorship rate at three and five years. The study highlights that while these procedures are complex, they offer durable long-term results for patients with failed prior fixation. These findings support conversion THA as a reliable salvage option with acceptable mid-term survivorship.

47. Kayani B, Enson J, Donaldson J, et al. Robotic Total Hip Arthroplasty in Atypical Hip Anatomy: Accuracy of Component Positioning and Clinical Outcomes in 192 Complex Cases. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.014

The study assessed the accuracy and clinical outcomes of robotic total hip arthroplasty in patients with atypical hip anatomy, such as developmental dysplasia. Robotic assistance achieved high accuracy in component positioning and resulted in excellent functional outcomes and high patient satisfaction. These results indicate that robotic THA is a reliable option for complex anatomical variations.

68. Karisch Q, Stamp J, Heller C, et al. Do Borderline Hips Show a Similar Response to Periacetabular Osteotomy as Frank Hip Dysplasia? A Cohort Study. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2026.101166

This cohort study compared clinical outcomes following periacetabular osteotomy in patients with borderline hip dysplasia versus those with frank hip dysplasia. The research aimed to determine if patients with borderline anatomy derive similar symptomatic and functional benefits from the procedure as those with more severe deformity. The findings provide evidence to guide surgical decision-making and patient counseling regarding the efficacy of joint preservation in borderline cases.

Patient-Reported Outcomes and Healthcare Policy (7)

10. Williams DH. Measuring Pain and Function. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.26.00472

Williams discusses Valsamis et al.'s study showing that postoperative Oxford scores and their change, rather than preoperative scores, strongly correlate with patient satisfaction after hip and knee replacement. The key finding suggests that preoperative patient-reported outcome measures are poor predictors of satisfaction, while postoperative metrics serve as better anchors. This implies that healthcare systems should prioritize postoperative satisfaction data when designing evidence-based access policies and evaluating surgical value.

16. Valsamis EM, Dufresne M, Chambers K, et al. Minimal and Substantial Improvement Thresholds for Oxford Scores Following Primary Hip and Knee Replacement Based on Patient Satisfaction. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.26.00175

Valsamis et al. investigated the ability of Oxford Hip and Knee Scores to predict patient satisfaction and established thresholds for minimal and substantial clinical benefit. The key finding reveals that postoperative scores and their change from baseline correlate well with satisfaction, whereas preoperative scores do not, allowing for the identification of specific score thresholds. These findings support the use of postoperative Oxford scores as reliable anchors for value-based healthcare policies and patient counseling regarding expected outcomes.

41. Lyman S, Chin A, Alschuler DM, et al. A Proposed Alternative Sampling Strategy for Centers for Medicare & Medicaid Services Arthroplasty Patient-Reported Outcome Performance Measure Compliance. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.003

The authors calculated the minimum sample size required to generate statistically valid patient-reported outcome performance measure estimates for hospitals of varying volumes. They found that the current CMS mandate of 50% compliance yields unreliable estimates for low-volume centers and unnecessarily large samples for high-volume ones. This suggests a need for a volume-adjusted sampling strategy to improve the accuracy and efficiency of performance monitoring.

52. Parry M, Ozdag Y, Kloc A, et al. Social Determinants of Health Z-Codes are Associated with Low Compliance with Patient-Reported Outcome Measures after Total Hip Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.022

This retrospective cohort study investigated the relationship between Social Determinants of Health (SDOH) codes and compliance with patient-reported outcome measures after total hip arthroplasty. The analysis revealed that specific SDOH factors were significantly associated with lower compliance rates for completing these surveys. These results indicate that healthcare systems should implement targeted interventions to improve PROM completion among patients facing social barriers.

55. Buller LT, Luo TD, Deckard ER, et al. Obesity and Chronic Opioids Were Not Negatively Associated with Achieving Centers for Medicare and Medicaid Services Mandated Thresholds for Hip Disability and Osteoarthritis Outcome Score for Joint Replacement Scores After Primary Total Hip Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.024

This study evaluated predictors of achieving CMS-mandated HOOS JR improvement thresholds after primary total hip arthroplasty, finding that obesity and chronic opioid use were not negatively associated with meeting these outcome targets. Most patients achieved the required improvement regardless of these commonly cited risk factors. These results argue against excluding obese or opioid-using patients from THA based on concerns about failing to meet mandated outcome benchmarks.

60. Driessche AM, Zamzam M, Hodson N, et al. Factors Associated with Patient-Reported Outcome Measure Non-Completion One Year after Total Joint Arthroplasty: A Retrospective Cohort Study. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.031

This retrospective cohort study analyzed factors associated with non-completion of one-year patient-reported outcome measures (PROMs) in nearly 7,500 total joint arthroplasty patients. The research identified that inactive patient portals and specific demographic factors were significantly associated with lower PROM completion rates, which are critical for Medicare quality reporting. These findings highlight the need for targeted strategies to improve PROM adherence, particularly among patients with limited digital engagement.

63. Lee YJ, Clement ND, Asopa V, et al. The EQ-5D-3L Questionnaire Demonstrates Moderate Ceiling Effects at One and Two Years After Total Hip Arthroplasty: Preoperative Predictors and Clinical Implications. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.036

This prospective study of 7,871 primary total hip arthroplasties evaluated the prevalence and predictors of ceiling effects in the EQ-5D-3L questionnaire at one and two years postoperatively. Nearly half of the patients reached the ceiling score, particularly women, younger individuals, and those with higher preoperative function, limiting the tool's ability to detect further improvement. Clinicians should consider alternative outcome measures for patients likely to achieve high baseline scores to better assess postoperative gains.

Hip Fracture Management and Geriatric Outcomes (5)

13. Keating J. Does the Use of Liposomal Bupivacaine in Hip Fracture Surgery Have Any Advantage Over Conventional Analgesia for Postoperative Pain Control?. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.26.00574

Précis unavailable.

25. Yu X, Yuan Y, Zhao S, et al. Incisional Infiltration of Liposomal Bupivacaine in Geriatric Hip Fracture Surgery. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.25.01498

This randomized trial evaluated whether adding liposomal bupivacaine to multimodal analgesia improves postoperative pain and recovery in geriatric hip fracture surgery. The study aimed to determine if this intervention provides clinically relevant advantages in resting pain, activity-related pain, and opioid consumption. The findings contribute to the ongoing debate regarding the efficacy of liposomal bupivacaine in orthopedic pain management.

53. Chen XT, Springer BD, Borkar S, et al. A Contemporary Comparison of Modern Cementless to Cemented Femoral Stems for Treatment of Femoral Neck Fractures. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.005

This study compared outcomes of cemented versus cementless femoral fixation for femoral neck fractures, finding that while cementless stems were used in younger patients, propensity-matched analysis showed no significant difference in periprosthetic fracture or mortality rates. The data challenges the assumption that cemented fixation is strictly superior regarding periprosthetic fracture risk in modern practice. Clinicians may consider cementless options for younger, healthier patients to avoid bone-cement implantation syndrome without compromising safety.

64. Wier J, Jones IA, Kumaran P, et al. Neutrophil-Lymphocyte Ratio Trajectories Predict Mortality and Medical Complications in Hip Fracture Patients Undergoing Hemiarthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.037

This study used latent profile analysis on neutrophil-lymphocyte ratio (NLR) trajectories in 9,282 hip fracture patients to identify inflammatory phenotypes predictive of mortality and complications. Patients with delayed or non-resolving NLR trajectories had significantly higher adjusted odds of mortality and medical complications compared to those with blunted or resolving phenotypes. Monitoring NLR trajectories can help identify high-risk patients requiring closer medical management after hemiarthroplasty.

69. Jowkar N, Ruffner M, Koltenyuk V, et al. Risk Stratification in Periprosthetic Hip Fracture Surgery: The Risk Analysis Index is Superior to the Five-Item Modified Frailty Index for Predicting 30-Day Complications. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.043

This study compared the predictive performance of the Risk Analysis Index (RAI) and the Five-Item Modified Frailty Index (mFI-5) for 30-day complications in patients undergoing surgery for periprosthetic hip fractures. The analysis revealed that the RAI was superior to the mFI-5 in accurately stratifying risk for major and minor postoperative complications. These results suggest that the RAI should be preferred for preoperative risk assessment to better inform surgical planning and resource allocation.

2. Kahana‐Rojkind AH, Cohen MF, Strok MJ, et al. Athletes Undergoing Staged Bilateral Hip Arthroscopy Show Favorable Midterm Outcomes and Return to Sport: A Propensity‐Matched Study. Arthroscopy 2026. doi:10.1002/arj.70385

This propensity-matched study evaluated midterm outcomes and return-to-sport rates in high-level athletes undergoing bilateral versus unilateral hip arthroscopy. Bilateral athletes demonstrated favorable midterm patient-reported outcomes and high return-to-sport rates comparable to their unilateral counterparts. This supports the safety and efficacy of staged bilateral procedures for elite athletes seeking simultaneous treatment of bilateral pathology.

4. Yang X, Yang Z, Huang B, et al. Correspondence-free local-to-global liver deformation correction via implicit neural representation and biomechanical model. International Journal of Computer Assisted Radiology and Surgery 2026. doi:10.1007/s11548-026-03737-6

This erratum corrects typographical and data errors in previously published articles regarding hip replacement terminology, spinal fixation methodology, and deep-vein thrombosis incidence. The corrections ensure the accuracy of reported clinical scores, methodological descriptions, and statistical results in the medical literature. Accurate data reporting is essential for the validity of future research and clinical guidelines derived from these studies.

8. Zhang H, Chang Y, Zhou X, et al. Hip‐Combined Rotational Morphology Has Little Short‐Term Impact on Clinical Outcomes Following Hip Arthroscopy in Patients With Femoroacetabular Impingement Syndrome. Arthroscopy 2026. doi:10.1002/arj.70330

This study examined the association between hip combined rotational morphology and clinical outcomes following hip arthroscopy for femoroacetabular impingement syndrome. The analysis revealed that variations in femoral and acetabular version combinations had little short-term impact on patient-reported outcomes or return to function. Preoperative rotational morphology assessment may have limited utility in predicting short-term success following hip arthroscopy.

12. Zhu J, Ding R, Huang Y, et al. Association of Central Acetabular Osteophytes With Microinstability and Increased Combined Anteversion in Borderline Dysplasia Hips. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261453074

Zhu et al. conducted a case-control study comparing radiographic and intraoperative findings in borderline developmental dysplasia of the hip patients with and without central acetabular osteophytes. The key finding indicates that hips with osteophytes exhibit increased combined anteversion and a higher incidence of microinstability and ligamentum teres pathology. This suggests that central acetabular osteophytes are associated with altered hip biomechanics and instability, potentially influencing surgical decision-making in borderline dysplasia.

15. Ruberto RA, Mastroianni MA, Geller J, et al. The Effects of Surgeon Workforce Diversity on Total Joint Arthroplasty Patient Demographics. Journal of the American Academy of Orthopaedic Surgeons 2026. doi:10.5435/jaaos-d-25-01032

Ruberto et al. retrospectively analyzed patient demographics and outcomes following the hiring of an underrepresented minority (URM) surgeon in a predominantly non-URM practice. The key finding indicates that the presence of a URM surgeon was associated with increased diversity in patient race and ethnicity, though patient-reported outcome measures remained comparable across groups. This suggests that increasing surgeon workforce diversity may help address racial disparities in total joint arthroplasty utilization without compromising clinical outcomes.

20. Al Abdallat AM. Advancing Immune Cell Profiling in Arthroplasty Failure: Insights from Transcriptomic Deconvolution. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.26.00427

This commentary discusses a study applying transcriptomic deconvolution to analyze immune cell microenvironments in periprosthetic tissues across different arthroplasty failure etiologies. The approach identified distinct inflammatory signatures, such as elevated plasma cells and CD8+ T cells, in periprosthetic joint infection compared to aseptic failure. This novel profiling method offers potential insights for improving the differentiation of infection from aseptic loosening in clinically equivocal cases.

22. Abdeen A. [18F]-Fluoride PET/CT Is a Promising Technology for the Assessment of Osseointegration of Acetabular Components in Total Hip Arthroplasty. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.26.00003

This commentary highlights the potential of [18F]-Fluoride PET/CT as a promising technology for assessing osseointegration of acetabular components in total hip arthroplasty. It discusses how this imaging modality can evaluate postoperative bone mineralization adjacent to cups, offering a more dynamic assessment of fixation than traditional methods. The technology may enhance the ability to monitor biologic integration and predict long-term component stability in clinical practice.

23. Hoit G, Whelan DB, Dwyer T, et al. Treatment of Patients With Femoroacetabular Impingement Syndrome Using a Pelvic Tilt–Focused Exercise Program: A Prospective Cohort. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261454648

This prospective cohort study assessed the effectiveness of a standardized, pelvic tilt-focused home exercise program for the nonoperative management of femoroacetabular impingement syndrome. Patients demonstrated significant improvements in patient-reported outcomes, including iHOT-33 scores and pain levels, over a six-month period with high adherence to the brief daily regimen. The findings support pelvic tilt-focused exercises as an effective conservative treatment option, potentially reducing the need for surgical intervention.

24. Kurk MB, Keskin A, Tuzel M, et al. Spinopelvic mobility and rotational morphology in patients with femoroacetabular impingement‐like hip pain without classical imaging findings. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70494

This retrospective comparative study evaluated spinopelvic mobility and rotational morphology in patients with femoroacetabular impingement-like hip pain but without classical imaging findings. The results indicated that these patients exhibited altered spinopelvic parameters and rotational morphology compared to controls, with a subset demonstrating rigid spinopelvic behavior. These findings suggest that spinopelvic mechanics and rotational anomalies may contribute to hip pain in the absence of structural impingement, warranting consideration in diagnostic and treatment planning.

26. Mulpuri K. Are Post-Reduction Changes in Femoral Head Perfusion an Indicator for the Development of Proximal Femoral Growth Disturbance in the Surgical Management of Developmental Dysplasia of the Hip?. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.25.01597

This long-term follow-up study assessed the impact of avascular necrosis on hip function in patients who underwent closed reduction for developmental dysplasia. It found that avascular necrosis frequently leads to severe osteoarthritis, pain, and functional loss decades later. The results suggest that preventing lateral and proximal subluxation is critical to mitigating these poor long-term outcomes.

27. Lawrie C, Burnikel A, Riesgo A, et al. A Review of Fluoroscopy in Direct Anterior Approach Total Hip Arthroplasty: Principles, Safety, and Clinical Applications. Journal of the American Academy of Orthopaedic Surgeons 2026. doi:10.5435/jaaos-d-25-01523

This review examines the principles, safety, and clinical applications of using fluoroscopy during direct anterior approach total hip arthroplasty. It highlights how fluoroscopy improves component accuracy and reduces leg length discrepancies while maintaining surgical efficiency. The authors provide practical guidance on optimizing C-arm positioning and minimizing radiation exposure.

29. Robinson RP. Putting the Problem of Dislocation Following Total Hip Arthroplasty into Perspective by Recalling the Past. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.25.01343

Précis unavailable.

31. Heiting C, Wu Y, Goodman SM, et al. A Machine Learning Approach to Determine the Optimal Age for Total Hip Arthroplasty: When Is Risk for Adverse Outcomes Lowest?. Journal of the American Academy of Orthopaedic Surgeons 2026. doi:10.5435/jaaos-d-25-01248

This article describes the extended lesser trochanteric osteotomy (ELTO) as an alternative to the standard extended trochanteric osteotomy in complex revision hip arthroplasty. The ELTO technique allows for medial access to the femoral stem while preserving abductor attachments, potentially eliminating the need for postoperative bracing. It offers a faster approach with reduced risk of trochanteric nonunion and abductor weakness.

33. Siddiqi A, Jacob PB, Yousuf KM. Total Joint Arthroplasty During Ramadan. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.26.00276

This article synthesizes physiologic and perioperative considerations for performing total joint arthroplasty during Ramadan, addressing alterations in hydration, glycemic variability, and sleep architecture. It proposes a framework for risk stratification and shared decision-making, concluding that elective surgery is not inherently contraindicated but requires structured perioperative planning. Clinicians should implement specific management strategies to mitigate risks associated with prolonged fasting in this patient population.

36. Subramanian T, Oles A, Halayqeh S, et al. Systematic Review of Wound Complications After Direct Anterior Approach Total Hip Arthroplasty: Incidence, Risk Factors, and Management Strategies. Journal of the American Academy of Orthopaedic Surgeons 2026. doi:10.5435/jaaos-d-25-01035

This systematic review analyzed wound complications following direct anterior approach total hip arthroplasty, identifying superficial dehiscence and surgical site infections as the most frequent issues among over 35,000 procedures. The meta-analysis compared incision types and management strategies, revealing heterogeneous data on risk factors and optimal closure techniques. Understanding these complication profiles helps surgeons implement targeted prevention and management protocols to reduce postoperative morbidity.

37. Cohen-Rosenblum A, Heckmann N, Manktelow A, et al. A Concise Update on Decision-Making and Optimal Techniques in Revision Total Hip Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.074

This symposium article provides a concise update on decision-making and optimal techniques for revision total hip arthroplasty, drawing on concepts presented at the 2025 AAHKS Annual Meeting. It offers an overview of current surgical strategies and considerations for managing complex revision cases. The content serves as a practical guide for surgeons seeking to refine their approach to revision hip surgery.

38. Diaz Dilernia F, Vasarhelyi E, Lanting B, et al. Functional Outcomes, Complications, and Survivorship After Simultaneous Bilateral Total Hip Arthroplasty: A Retrospective Cohort Study with a Median Follow-up of 4.6 Years. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.001

This retrospective cohort study evaluated simultaneous bilateral total hip arthroplasty, finding excellent functional outcomes, low complication rates, and high implant survivorship at a median follow-up of 4.6 years. The procedure resulted in significant improvements in pain and function with a 95.7% survivorship rate when revision was the endpoint. Simultaneous bilateral THA remains a safe and effective option for eligible patients under contemporary perioperative protocols.

39. Katanbaf R, Misch M, Aflatooni JO, et al. Outcomes of Total Hip Arthroplasty Based on Surgeon Fellowship and Case Volume. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.004

This large-scale retrospective study compared outcomes of primary total hip arthroplasty performed by fellowship-trained versus non-fellowship-trained surgeons, stratified by case volume. High-volume fellowship-trained surgeons demonstrated significantly lower rates of mechanical complications, such as dislocation and periprosthetic fracture, compared to other groups. These findings suggest that combining fellowship training with high case volume optimizes specific mechanical outcomes in primary THA.

40. Unknown Author. Issue Information. Arthroscopy 2026. doi:10.1002/arj.70426

This issue information page lists the table of contents for the June 2026 issue of Arthroscopy, highlighting various studies on shoulder, hip, and knee procedures. It includes articles on rotator cuff tears, shoulder stabilization, adolescent hip arthroscopy, ACL reconstruction, and return to sport in elite athletes. The content reflects current research and clinical innovations in arthroscopic and related surgical practices.

42. Paul BR, Verhey JT, Tarabichi S, et al. Aspirin is Associated with Improved Venous Thromboembolism Prophylaxis Compared with Anticoagulants After Total Hip Arthroplasty in Patients Who Have Prior Hematologic Malignancy. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.006

This study compared venous thromboembolism (VTE) prophylaxis outcomes in patients with prior hematologic malignancies undergoing total hip arthroplasty, finding that aspirin was associated with significantly lower DVT rates than non-aspirin anticoagulants. There were no significant differences in pulmonary embolism, bleeding, or mortality between the groups. These findings support aspirin as a safe and effective VTE prophylaxis option for this high-risk population.

44. Yapp LZ, Howard LC, Greidanus NV, et al. First Revision Total Hip Arthroplasty for Instability: 10-Year Outcomes and Risk Factors Associated with Re-Revision. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.002

This study evaluated 10-year survivorship and risk factors for re-revision after the first revision total hip arthroplasty performed for instability. Dual mobility components showed higher instability-free survival compared to standard bearings and constrained liners, though overall 10-year survivorship remained moderate. The findings highlight the potential benefit of dual mobility implants in reducing recurrent instability after revision surgery.

45. Acuña AJ, Potluri AS, Yadav AS, et al. Revision Total Joint Arthroplasty at the Ambulatory Surgery Center: A Single Institutional Experience. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.009

The authors reported outcomes of revision total joint arthroplasty performed at an ambulatory surgery center, finding low 90-day complication rates and high survivorship free of re-revision. The majority of procedures involved modular component exchanges for instability. This suggests that revision TJA can be safely and effectively performed in the outpatient setting for appropriately selected patients.

46. Okazaki T, Imagama T, Matsuki Y, et al. Comparing Clinical and Radiological Outcomes for a Three-Dimensional Printed Highly-Porous Cup and a Hydroxyapatite-Coated Non-Highly-Porous Cup in Total Hip Arthroplasty Using Propensity Score Matching. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.011

This study compared clinical and radiological outcomes of three-dimensional printed highly-porous acetabular cups against hydroxyapatite-coated non-highly-porous cups in total hip arthroplasty. Clinical outcomes and radiological parameters, including cup migration and loosening, did not differ significantly between the two groups at two years. Both cup types appear to provide comparable short-term clinical and radiological success.

48. Lee D, Park J, Jung W, et al. Complications of Ceramic-on-Ceramic Total Hip Arthroplasty with Large Heads: 10-Year Minimum Follow-Up. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.015

This long-term study evaluated complications and survivorship of ceramic-on-ceramic total hip arthroplasty with large heads at a minimum of 10 years. The results showed low rates of ceramic fracture and noise, with good long-term clinical and radiographic outcomes. Ceramic-on-ceramic bearings with large heads remain a durable option with acceptable long-term safety profiles.

49. Murphy MP, Forti CR, Ho H, et al. What Factors Increase the Risk of Dislocation after Primary Total Hip Arthroplasty Using the Direct Anterior Approach?. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.017

This study analyzed 8,658 primary total hip arthroplasty cases using the direct anterior approach to identify risk factors for dislocation, finding a 0.5% overall rate with women and those receiving 28 mm heads at higher risk. The key finding highlights specific demographic and implant size vulnerabilities within this low-complication approach. Clinically, these insights suggest targeted monitoring or implant selection adjustments for high-risk subgroups to further minimize dislocation events.

50. Ruff G, Di Pauli von Treuheim T, Sarfraz A, et al. How Do Operating Room Timings Differ Between Anterior and Posterior Approaches for Total Hip Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.012

Researchers compared operating room timings between anterior and posterior approaches for primary total hip arthroplasty in over 8,000 procedures, finding that the anterior approach significantly reduced total OR time and several specific procedural intervals. This efficiency gain persists even after controlling for various patient and surgical confounders. The findings support the anterior approach as a viable option for improving surgical throughput and resource utilization.

51. Saluja A, Eschert J, Ren R, et al. Propensity Score-Matched Comparison of Patient-Reported Outcomes Between Crowe I Developmental Dysplasia of the Hip and Primary Osteoarthritis Following Total Hip Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.023

This propensity-score matched study compared patient-reported outcomes between patients with Crowe I developmental dysplasia of the hip and those with primary osteoarthritis following total hip arthroplasty. The results demonstrated comparable improvements in functional scores and similar implant survivorship between the two groups at minimum two-year follow-up. These findings suggest that Crowe I DDH patients can expect outcomes similar to primary OA patients, supporting THA as an effective treatment for this population.

54. Sambare TD, Royse KE, Son SJ, et al. Triple-Taper Stems in Obese Total Hip Arthroplasty Patients: Complication and Revision Rates from a U.S. Registry. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.063

Analyzing a large registry of obese patients undergoing primary total hip arthroplasty, this study found that triple-taper femoral stems were associated with the lowest cumulative aseptic revision rates at five years compared to single or dual-taper designs. The benefit was particularly pronounced in patients with Class I obesity. These findings suggest that triple-taper stems may offer superior long-term stability and reduced revision risk in the obese population.

58. Won S, Lee S, Bahk J, et al. Time-Dependent Revision Risk and Failure Modes After Total Hip Arthroplasty and Hemiarthroplasty for Displaced Femoral Neck Fracture in Patients Younger Than 70 Years: A Multicenter Analysis of 1,176 Consecutive Cases. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.032

This multicenter analysis of 1,176 patients younger than 70 years compared revision risks and failure modes between total hip arthroplasty (THA) and hemiarthroplasty (HA) for displaced femoral neck fractures. While revision rates were similar initially, THA demonstrated superior long-term survival after 5.5 years, with dislocation being the primary failure mode for THA and infection for HA. These results suggest THA may offer better durability in younger patients, though failure mechanisms differ significantly between the two procedures.

61. Bellissimo J, Hall B, Hali K, et al. Internet Promotion of Orthobiologics by the American Association of Hip and Knee Surgeons Members: Claims Versus Evidence in Patient-Facing Websites. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.040

This cross-sectional content analysis evaluated 4,683 websites of AAHKS members to compare online claims for orthobiologic therapies against current peer-reviewed evidence. The study found that while orthobiologics were mentioned on 12.3% of sites, the promotional claims often exceeded the strength of available scientific evidence regarding efficacy and risks. This discrepancy suggests a need for more accurate, evidence-based communication of orthobiologic benefits to patients.

62. Buller LT. Proceedings of the 2025 American Association of Hip and Knee Surgeons Annual Meeting. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.054

This article serves as the proceedings for the 2025 American Association of Hip and Knee Surgeons Annual Meeting, summarizing key presentations and discussions from the event. It provides an overview of the latest research and clinical updates presented by leading experts in the field of hip and knee surgery. The content reflects the current state of knowledge and emerging trends discussed at the meeting.

66. Holle AM, Moore ML, Henderson AP, et al. Declining Medicaid Reimbursement for Total Hip and Knee Arthroplasty from 2014 to 2022: A Comparison of Expansion and Non-Expansion States. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.047

This study analyzed national and state-level trends in inflation-adjusted Medicaid physician reimbursement for total hip and knee arthroplasty from 2014 to 2022. Results indicated a significant decline in reimbursement for both procedures, with total knee arthroplasty decreasing by 22.0% and total hip arthroplasty by 31.9%, regardless of Medicaid expansion status. These declining financial incentives may impact provider participation and access to joint replacement services for Medicaid beneficiaries.

67. Chen Y, Cao L, Ji B, et al. Efficacy of Intraosseous Tranexamic Acid in Primary Total Hip Arthroplasty: A Prospective Randomized Controlled Trial. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.065

This prospective randomized controlled trial compared the efficacy of intraosseous, intravenous, and topical tranexamic acid administration in reducing blood loss during primary total hip arthroplasty. The study demonstrated that intraosseous administration was noninferior to intravenous and topical routes regarding hemoglobin reduction and transfusion rates. Clinically, this supports intraosseous tranexamic acid as a viable alternative for minimizing perioperative blood loss.

71. de Geofroy B, Argenson J, Sculco PK, et al. Temporal Trends in Revision Burden Ratio for Hip and Knee Arthroplasty: A Comparative Analysis of Large National Registries. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.046

This registry-based observational study analyzed temporal trends in the revision burden ratio for hip and knee arthroplasty across four national registries from the UK, Australia, the US, and Sweden. The results showed that while primary volumes increased, the knee-to-hip revision burden ratio increased globally, indicating a higher relative revision burden for knees. These trends underscore the growing challenge of revision surgery and the need for improved implant longevity and surgical techniques.

72. Ihekweazu UN, Walton S, Hannon CP. The American Association of Hip and Knee Surgeons Position Statement on Outpatient Joint Replacement. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.063

This position statement from the American Association of Hip and Knee Surgeons outlines guidelines and considerations for the safe implementation of outpatient joint replacement. It addresses patient selection criteria, perioperative care pathways, and necessary infrastructure to support same-day discharge procedures. The statement aims to standardize practices and ensure high-quality outcomes as the healthcare system shifts toward more efficient outpatient surgical models.

73. Heo KY, McCall M, Sheth N, et al. Rising Volume of Periprosthetic Fractures After Primary Total Hip and Knee Arthroplasty: A Contemporary Epidemiologic Analysis. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.058

This study analyzed national databases to quantify emergency department visits and surgical management for periprosthetic hip and knee fractures from 2017 to 2022, projecting trends through 2035. The authors found a significant rise in the volume of these fractures, correlating with the increasing number of primary arthroplasties. These findings highlight the growing burden of periprosthetic fractures, necessitating enhanced preparedness for emergency and operative care in orthopedic practice.

74. Culler MW, Iyer A, Lim MA, et al. Reassessing Total Joint Arthroplasty Case Volumes in The United States: Accounting for Ultra-Low-Volume Surgeons. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.067

Researchers reassessed total joint arthroplasty (TJA) volume trends by excluding ultra-low-volume surgeons from national insurer data to better reflect typical surgical caseloads. They discovered that while mean surgeon volume appeared stable, the average caseload for a typical patient's surgeon was significantly higher when ultra-low-volume outliers were removed. This adjustment provides a more accurate representation of surgeon productivity and may influence policy regarding volume thresholds for TJA providers.

75. De Leo D, Temporiti F, Guzzetti L, et al. Minimal Clinically Important Difference of the Timed Up and Go Test, 10-Meter Walk Test, and 2-Minute Walk Test in Patients in the Acute Phase After Total Hip Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.062

This prospective study determined the Minimal Clinically Important Difference (MCID) for the Timed Up and Go, 10-Meter Walk, and 2-Minute Walk tests in the acute phase after total hip arthroplasty. The results indicated high variability in MCID estimates across different statistical methods for all three functional tests. Clinicians should interpret these mobility metrics with caution in early postoperative assessments due to the lack of consistent, definitive thresholds for clinical improvement.

76. Burgio C, Driscoll D, El-Hassan M, et al. What are the Rates of Recurrent Dislocation and Re-Revision after Revision Total Hip Arthroplasty for Instability?. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.069

The study evaluated rates of recurrent dislocation and re-revision following revision total hip arthroplasty (rTHA) for instability, identifying associated risk factors. They found that 14.9% of patients experienced recurrent dislocation and 11.2% required re-revision, with prior spinal fusion significantly increasing the risk of failure. These data suggest that patients with prior spinal fusion require heightened surveillance and potentially modified surgical strategies to mitigate instability risks.

77. Giannakis P, Rowe JE, Ren R, et al. Trends of In-Hospital Mortality after Inpatient Elective Total Hip and Knee Arthroplasty: A 2016 to 2023 Population-Based Study. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.068

This population-based study analyzed in-hospital mortality trends for elective inpatient total hip and knee arthroplasty from 2016 to 2023. The authors reported a tripling of mortality rates for THA and a significant increase for TKA, alongside rising costs associated with mortality-related hospitalizations. These trends underscore the need for improved perioperative risk management and resource allocation as arthroplasty volumes grow among older, comorbid patients.

78. Elmenawi KA, Zaniletti I, Poilvache H, et al. Distribution of Total Hip Arthroplasty Periprosthetic Infection Care in the United States: Reported from the American Joint Replacement Registry. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.077

Using the American Joint Replacement Registry, this study mapped the distribution of total hip arthroplasty periprosthetic joint infection (PJI) care across US institutions and surgeons. The analysis revealed that median annual volumes for both institutions and surgeons are low, with high-volume centers performing a minority of these complex revisions. These findings challenge the feasibility of centralizing all PJI care into limited centers of excellence and suggest a more distributed care model may be necessary.

79. Javidmehr S, Ramezanpour MR, Vaziri AS, et al. Total Knee and Hip Arthroplasty in Patients Who Had Prior Septic Arthritis: A Systematic Review and Meta-Analysis. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.056

This systematic review and meta-analysis assessed the risk of periprosthetic joint infection (PJI) in patients undergoing total knee or hip arthroplasty after prior septic arthritis. The pooled PJI rate was found to be 2.6%, with higher risks observed in total knee arthroplasties compared to total hip arthroplasties. These results provide surgeons with critical baseline risk data to counsel patients and plan surgical strategies for this high-risk population.

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c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

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