Newsroom Hospital for Special Surgery

HSS Reports Results of Key Studies on Targeted Medication Use in Joint Replacement Surgery

Mon, 02 Mar 2026 15:08:00 -0500

Hospital for Special Surgery (HSS), the world’s leading academic medical center focused on musculoskeletal health, today announced the results of several critical studies examining the use of targeted medications in joint replacement surgery to improve patient outcomes. These studies address key questions in perioperative medication management, an area that directly affects recovery, safety, and long‑term outcomes for joint replacement patients. The findings, presented at the annual meeting of the American Academy of Orthopaedic Surgeons (AAOS), evaluated outcomes following hip and knee replacement procedures.

The first of the three studies, “Aspirin Versus Potent VTE Chemoprophylaxis (VTEC) in Total Knee Arthroplasty: Reduced Postoperative Pain and Complications with Aspirin Use,” examined the experience of total knee arthroplasty (TKA) patients with postoperative pain who were also taking blood thinners. The study included 28,169 patients treated between 2016 and 2023; 18,413 received aspirin while 9,756 received a potent VTE.. Patients were monitored for 90 days following their procedure. The findings suggest that aspirin should be considered the preferred option for reducing postoperative pain in TKA patients.

Patients on more-potent blood thinners tend to experience more pain, swelling and inflammation after surgery, said Brian P. Chalmers, MD, a hip and knee surgeon at HSS and one of the study’s authors. “We have always known that non-steroidal anti-inflammatory medications can improve patients’ swelling and inflammation after surgery. However, the traditional thought and belief has been that we should avoid those in patients on anticoagulation. Our data show there is less risk and less postoperative pain when these patients are utilizing aspirin.”

A second study, “The Effect of Concomitant Use of Potent Anticoagulation and Anti-Inflammatories on Early Outcomes of Total Hip Arthroplasty,” retrospectively evaluated 5,881 total hip arthroplasty patients who were on anticoagulation. The surgeries were performed between 2016 and 2023; of those patients, 4,867 were concomitantly prescribed NSAIDs and 1,040 received anticoagulation alone. Researchers concluded that the concomitant use of NSAIDs in patients on anticoagulants did not increase the risk of wound-related bleeding complications.

“The conventional thinking has often been that patients on an anticoagulant should not be on an NSAID, that there is going to be bleeding, more risk of wound problems and additional complications. But based on our retrospective data, we did not see increased risk in patients using both anticoagulation and NSAIDs. We did see some additional benefits, including less pain and a somewhat easier recovery,” Dr. Chalmers stated. “NSAIDs appear to be safe in this setting and may help decrease postoperative pain and reduce opioid use following surgery.”

The final study, “Cefazolin and the R-1 Side Chain: Why Your Joint Arthroplasty Patients With Cephalosporin Allergy Can Safely Be Given Cefazolin,” assessed the safety and effectiveness of the antibiotic Cefazolin in patients with documented cephalosporin allergies. This is the first study to evaluate these questions.

From 2016 to 2024, researchers compared patients with a reported cephalosporin allergy who received perioperative cefazolin with those who received alternative antibiotic prophylaxis. This study included 89,993 hip and knee arthroplasty patients. Of these, 1,267 had a documented allergy. The study resulted in zero incidence of IgE-mediated or “severe” type IV allergic reactions, concluding that cefazolin can be safely administered to most patients with an existing cephalosporin allergy.

“When patients have a mild allergic reaction, there is often a reflex to give them another antibiotic in a different family of drugs. However, alternative options aren’t always as effective,” said Matthew S. Austin, MD, hip and knee surgeon at HSS and a study author. “Clear protocols should be put in place to guide decision-making when managing these types of allergies.”

These findings underscore HSS’s ongoing commitment to challenging conventional assumptions and using data-driven research to refine perioperative care. The studies highlight how targeted medication strategies can improve safety, reduce complications and enhance outcomes for patients undergoing hip and knee arthroplasty.

Study Details

“Aspirin Versus Potent VTE Chemoprophylaxis in Total Knee Arthroplasty: Reduced Postoperative Pain and Complications with Aspirin Use”

Alex Anatone, Alexis Gabriel Gonzalez, Richard Hwang, David Andrew Kolin, Aaron Ira Weinblatt, Amar S Ranawat, Alejandro Gonzalez Della Valle, Brian Chalmers

“The Effect of Concomitant Use of Potent Anticoagulation and Anti-Inflammatories on Early Outcomes of Total Hip Arthroplasty”

Alexis Gabriel Gonzalez, Aaron Ira Weinblatt, Agnes Cororaton Jones, Stephen Lyman, Richard Hwang, Alex Anatone, Carlo Marega, Alejandro Gonzalez Della Valle, Brian Chalmers

“Cefazolin and the R-1 Side Chain: Why Your Joint Arthroplasty Patients With Cephalosporin Allergy Can Safely Be Given Cefazolin”

Josef Jolissaint, Katherine E Mallett, Andrew Thomson, Alberto V Carli, Matthew Austin

HSS Presents New Research at the AAOS Conference 2026

Mon, 02 Mar 2026 15:08:00 -0500

At this year’s American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting, HSS physicians and scientists presented exciting new research related to clinical advancements for care and patient outcomes in orthopedics.

HSS Reports Results of Key Studies on Targeted Medication Use in Joint Replacement Surgery

HSS today announced the results of several critical studies examining the use of targeted medications in joint replacement surgery to improve patient outcomes. These studies address key questions in perioperative medication management, an area that directly affects recovery, safety, and long‑term outcomes for joint replacement patients.

HSS Presents New Findings Impacting Pediatric Orthopedic Care Recommendations at AAOS Annual Meeting

HSS investigators presented several significant studies, two of which could lead to changes in how surgeons counsel families of young patients facing serious orthopedic conditions.

HSS Study Finds Infection Rates at a High-Volume Academic Orthopedic Center After Total Knee Arthroplasty are Low Regardless of Individual Surgeon Volume

A retrospective study by HSS investigators found that infection rates at a high-volume academic orthopedic center following total knee arthroplasty (TKA) are uniformly low regardless of individual surgeon volume. These findings challenge the long-held belief that a surgeon’s experience, not the institution’s, drives safety outcomes.

HSS Studies Highlight Advantages of Osseointegration for People with an Amputation

Three new studies from HSS highlight the use and advantages of osseointegration (OI) for individuals with an amputation, in some instances challenging prevailing beliefs about which patients would benefit.

Patients with iodine-related allergies may still receive iodine-based products during TJA

Mon, 02 Mar 2026 11:40:00 -0500

Healio reported on new research from HSS that finds patients who reported an iodine-related allergy prior to total joint arthroplasty did not experience a hypersensitivity reaction if they received an iodine-based product during surgery.

Matthew S. Austin, MD, hip and knee replacement surgeon at HSS, told Healio about results presented at the American Academy of Orthopaedic Surgeons Annual Meeting. “This study sheds light on the fact that if someone says they have an allergy to an iodine-related product one should not automatically avoid its use,” he said. Dr. Austin and colleagues retrospectively reviewed data from 3,696 patients who reported an allergy to iodine, iodine-containing products or shellfish who either did (n = 1,378) or did not (n = 2,318) receive an iodine-based product during primary TJA.

“Instead of a blanket policy of if a patient says they have an allergy to an iodine-based product, they cannot receive any iodine-based product, institutions can have a protocol in place where you look at the patient’s history,” Dr. Austin continued. “What is the patient saying the reaction was? How severe was the reaction? How far in the past? Have they safely received an iodine-related product in the interim since they discovered they had this allergy? Putting appropriate pathways and protocols in place will allow many patients to receive an iodine-based product, which may reduce their risk for having an infection from the procedure.”

Read the full article at healio.com.

Travel distance may not impact 90-day outcomes, complications after THA

Wed, 16 Oct 2024 22:08:00 -0400

Healio reports that according to published results, patients who traveled 40 miles or more to undergo total hip arthroplasty had similar 90-day outcomes and complication rates compared with patients who traveled fewer than 40 miles for surgery.

According to Matthew S. Austin, MD, hip and knee surgeon at HSS, “This was an interesting retrospective study that examined the effect of traveling a distance of greater than (“travelers”) or less than (“locals”) 40 miles for total hip arthroplasty and/or follow-up on patient-reported outcomes (PROs) and 90-day complications at a center of excellence. The two cohorts did not differ significantly in terms of preoperative demographics, with the exception of travelers having had lower average Harris Hip Scores. There were no differences in postoperative PROs, complications, readmissions or reoperations. Locals did visit the ED significantly more than travelers.”

Read the full article at healio.com.