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Contemporary Advances in Joint Arthroplasty: Optimizing Outcomes and Expanding Indications

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: closed (20 May 2026) | Viewed by 655

Editors


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Guest Editor
Department of Orthopedic Surgery, Larkin Community Hospital, South Miami, FL, USA
Interests: orthopedic surgery; regenerative medicine; shoulder arthroplasty; shoulder arthroscopy; artificial intelligence
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Joint arthroplasty remains one of the most successful and transformative interventions in modern orthopedics, offering profound pain relief and functional restoration for patients with end-stage joint disease. However, the field is rapidly evolving, driven by innovations in surgical techniques, implant design, perioperative care, and the management of complex cases. This Special Issue aims to capture the forefront of clinical research and practice in joint arthroplasty. We seek high-quality original research articles and comprehensive reviews focusing on optimizing patient outcomes through enhanced recovery protocols (ERAS), precision techniques (robotic-assisted surgery, computer navigation, patient-specific instrumentation), and novel bearing surfaces or implant materials. Additionally, we welcome contributions addressing the expansion of safe and effective indications, including management strategies for younger, higher-demand patients; complex primary arthroplasty (severe deformity, bone loss); and challenging revision scenarios. Topics of interest also encompass long-term survivorship analysis, complication mitigation (infection, instability, periprosthetic fracture), outcome measurement advancements, and cost-effectiveness analyses of new technologies. This issue will provide clinicians with evidence-based insights to refine surgical decision-making, improve patient selection, implement best practices, and ultimately deliver superior, durable results for a growing population requiring joint replacement.

Dr. Ashim Gupta
Dr. Hugo C. Rodriguez
Guest Editors

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Keywords

  • joint arthroplasty
  • total joint replacement
  • revision arthroplasty
  • robotic-assisted surgery
  • periprosthetic joint infection (PJI)
  • enhanced recovery after surgery (ERAS)
  • machine learning
  • artifical intelligence

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Published Papers (1 paper)

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Research

15 pages, 1127 KB  
Article
How Contaminated Is the Surgical Field in Reverse Total Shoulder Arthroplasty? A Preliminary Quantitative Intraoperative Microbiological Study
by Enrico Bellato, Michela Bersia, Francesca Menotti, Fabio Longo, Davide Blonna, Gabriele Vasario, Silvia Cortese, Eleonora Maniscalco, Lucrezia Massobrio, Paola Dalmasso, Giuliana Banche, Cristina Costa, Valeria Allizond and Filippo Castoldi
J. Clin. Med. 2026, 15(13), 5160; https://doi.org/10.3390/jcm15135160 - 2 Jul 2026
Viewed by 280
Abstract
Background/Objectives: Bacterial contamination of the surgical field during shoulder arthroplasty may contribute to periprosthetic joint infection (PJI), yet data on intraoperative bacterial load and its clinical correlates remain limited. This study aimed to evaluate culture positivity and bacterial load in specimens collected [...] Read more.
Background/Objectives: Bacterial contamination of the surgical field during shoulder arthroplasty may contribute to periprosthetic joint infection (PJI), yet data on intraoperative bacterial load and its clinical correlates remain limited. This study aimed to evaluate culture positivity and bacterial load in specimens collected at the end of reverse total shoulder arthroplasty (RTSA) and to explore their association with patient-related factors. Methods: Fifty-five patients undergoing elective RTSA were consecutively enrolled. At the end of surgery, three specimens per patient (two prosthetic swabs and one periprosthetic tissue sample) were collected for qualitative and quantitative microbiological analysis. Associations between bacterial load and clinical variables were assessed using mixed-effects linear regression models, while time to culture positivity was analysed using mixed-effects Cox regression models. Results: Among 165 specimens, Cutibacterium acnes was isolated in 42.4% and coagulase-negative staphylococci in 29.1%. C. acnes showed significantly higher bacterial loads (1.38 × 103 CFU/mL) compared with aerobic bacteria (6.54 × 101 CFU/mL). Higher C. acnes load was associated with male sex, older age, higher body mass index, smoking, and cuff tear arthropathy, whereas massive rotator cuff tear and longer time to positivity were inversely associated. Aerobic bacterial load was primarily associated with longer surgical duration. Time to positivity was shorter for aerobes than for C. acnes. Conclusions: Intraoperative bacterial contamination during RTSA is frequent and characterized by marked differences in bacterial load and growth kinetics. Quantitative assessment of bacterial burden may improve the interpretation of unexpected positive cultures. Full article
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