The American Academy of Orthopaedic Surgeons (AAOS) recently concluded their Annual Meeting from March 10-14 in San Diego, California. This esteemed event serves as the premier gathering for professionals in the field of orthopaedic surgery. The educational program showcased a diverse array of sessions, lectures, courses, and workshops tailored to address the latest advancements in orthopaedics across various specialties and career stages.

Today, we will explore some of the posters presented at the AAOS 2025. Let us delve into the highlights of the research focusing on total knee arthroplasty (TKA) and examine the cutting-edge advancements that are shaping the landscape of orthopedics.

Impact of Osteoporosis Medications on Postoperative Complications Following TKA

  • Intro: Bisphosphonates have long been the gold standard for osteoporosis treatment, but other medications such as Denosumab, SERMs, and Teriparatide have also shown efficacy.
  • Objective: This study aimed to examine the incidence and odds of postoperative complications following total knee arthroplasty (TKA) in patients taking different osteoporosis medications, including Denosumab, SERMs, Teriparatide, and Bisphosphonates, at 90 days, 1 year, and 2 years.
  • Conclusion: Teriparatide and Denosumab were associated with a higher incidence and odds of post-TKA complications compared to Bisphosphonates. These findings are important for guiding osteoporosis medication choices in patients considering TKA, contributing to better decision-making between patients and orthopedic surgeons.

High Altitude is an Independent Risk Factor for Postoperative Venous Thromboembolism Following Primary TKA

  • Intro: Venous thromboembolism (VTE) is a serious complication following total knee arthroplasty (TKA), and high altitude may increase the risk of VTE events.
  • Objective: This study aimed to determine if high altitude is an independent risk factor for postoperative VTE events following TKA.
  • Conclusion: High altitude was identified as an independent risk factor for VTE following TKA, with patients at elevations of 4000 feet or higher having increased odds of developing VTE and DVT at both 30 and 90 days post-surgery.

Superior Clinical Results With Intraosseous Vancomycin In Primary Total Knee Arthroplasty

  • Intro: Periprosthetic joint infection (PJI) is a serious and feared complication following total knee arthroplasty (TKA).
  • Objective: This study aimed to evaluate the long-term clinical follow-up of our initial findings on improved postoperative infection rates with intraosseous (IO) vancomycin compared to intravenous (IV) vancomycin for primary TKA.
  • Conclusion: Increased case numbers and longer follow-up confirmed that IO vancomycin reduced the rate of PJI compared to IV vancomycin at 90 days, with a trend toward significance at 1 year. Additionally, IO vancomycin was associated with a reduced incidence of acute kidney injury (AKI) after primary TKA.

Second Generation Antidepressants Significantly Increase the Risk of Postoperative Complications in Total Knee Arthroplasty

  • Intro: Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) are widely prescribed antidepressants in the United States, and recent evidence suggests they may affect bone health and quality.
  • Objective: This study aimed to evaluate the effect of SSRIs and SNRIs on 90-day postoperative outcomes following total knee arthroplasty (TKA).
  • Conclusion: The study found significantly worse outcomes in TKA patients with preoperative SSRI and SNRI prescriptions, highlighting the potential need to refine preoperative optimization practices to improve TKA outcomes.

Influenza Infection has Higher Risk of Postoperative Complications Compared to COVID-19 in Total Knee Arthroplasty Patients

  • Intro: Several studies have shown that COVID-19 negatively impacts postoperative outcomes following total knee arthroplasty (TKA), but recent improvements in care and immunity have reduced these complications.
  • Objective: This study aimed to compare clinical outcomes in TKA patients who contract influenza versus those who contract COVID-19.
  • Conclusion: The study found a significantly higher risk of postoperative complications in TKA patients who contracted influenza during the perioperative period, emphasizing the need for continued vigilance regarding influenza infection in TKA patients despite the focus on COVID-19.

Mid-Term Outcomes After Contemporary Cementless vs Cemented Primary TKA: Some Subtle Differences

  • Intro: Cementless total knee arthroplasty (TKA) has gained interest due to its potential for improved long-term survivorship and ease of use, though data on contemporary cementless TKA remains limited.
  • Objective:This study aimed to compare implant survivorship and outcomes between contemporary cementless and cemented TKA.
  • Conclusion:We found subtle differences in mid-term outcomes, with a slightly increased risk of infection in the cementless group, similar durability between titanium cementless and cemented tibias, and a higher risk of loosening with cobalt-chromium cementless tibias.

Are Morbidly Obese Patients Appropriate for TKA with Selective Patella Resurfacing?

  • Intro: Selective patella resurfacing in primary total knee arthroplasty (TKA) has seen a resurgence due to modern implants and awareness of complications from past studies. However, patient selection, particularly for obese patients, remains underexplored.
  • Objective: This study aimed to compare patient-reported outcomes (PROMs) for patients with BMI ≥40 who underwent contemporary TKA with and without selective patellar resurfacing.
  • Conclusion: Patients with BMI ≥40 showed functional improvements after primary TKA, with unresurfaced patella patients reporting higher activity levels and better pain relief during stair climbing. However, this improvement may be offset by a 10% difference in satisfaction, highlighting the need for further long-term follow-up.

The #AAOS2025 is set to be an enriching and informative event. We recommend clicking here to explore the comprehensive list of topics and sessions that will be covered at this significant event. Don’t miss the opportunity to expand your expertise.

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