Andrew L Thomson,Christina Chao,Mohammad Hammad,Mario Mendia,Mathias P G Bostrom,Alberto V Carli
BACKGROUNDRetained polymethylmethacrylate (PMMA) in surgical instrument trays and on instruments is becoming more common and is a disquieting situation for the arthroplasty operating room team. Although retained debris may be sterile after autoclaving, previous studies have not specifically investigated bacterial viability on retained PMMA. This study determined whether heavily contaminated PMMA surfaces and instruments covered in PMMA could be effectively sterilized by clinically utilized autoclaving protocols.METHODSMature methicillin-susceptible Staphylococcus aureus (MSSA) and Escherichia coli biofilms were grown on PMMA coupons with a smooth surface (n = 5 per condition) or with deep crevices (n = 5 per condition) and on threaded screws, which were inserted into polymerizing PMMA (n = 5 per condition). PMMA coupons and PMMA-covered screws were subjected to 3 autoclave sterilization protocols. Colony-forming unit (CFU) counts and adenosine triphosphate (ATP) levels were measured to detect viable bacteria. Scanning electron microscope (SEM) images were obtained to determine whether biofilm was present.RESULTSNon-autoclaved PMMA surfaces were heavily contaminated, with values of 4.1 ± 2.3 × 106 CFUs/mL for S. aureus and 2.4 ± 1.2 × 106 CFUs/mL for E. coli. ATP levels of 3,230 ± 1,297 relative light units (RLU) for S. aureus and 1,006 ± 602 RLU for E. coli were observed. Crevices and screws were also heavily contaminated. Following autoclaving, CFUs/mL counts of <10 and RLU levels of <5 (beneath the hygienic threshold for cleanliness) were recorded on all PMMA surfaces, crevices, and screws. SEM confirmed that the biofilm structures remained intact, but they did not contain viable bacteria.CONCLUSIONSPMMA and PMMA-covered instruments contaminated with gram-positive or gram-negative biofilms are effectively sterilized using clinical autoclaving protocols.CLINICAL RELEVANCERetained PMMA and PMMA-covered surgical instruments that undergo a clinical autoclaving protocol do not carry viable bacteria.
{"title":"Autoclaving Effectively Sterilizes Contaminated Retained Cement in Orthopaedic Surgical Trays.","authors":"Andrew L Thomson,Christina Chao,Mohammad Hammad,Mario Mendia,Mathias P G Bostrom,Alberto V Carli","doi":"10.2106/jbjs.25.00655","DOIUrl":"https://doi.org/10.2106/jbjs.25.00655","url":null,"abstract":"BACKGROUNDRetained polymethylmethacrylate (PMMA) in surgical instrument trays and on instruments is becoming more common and is a disquieting situation for the arthroplasty operating room team. Although retained debris may be sterile after autoclaving, previous studies have not specifically investigated bacterial viability on retained PMMA. This study determined whether heavily contaminated PMMA surfaces and instruments covered in PMMA could be effectively sterilized by clinically utilized autoclaving protocols.METHODSMature methicillin-susceptible Staphylococcus aureus (MSSA) and Escherichia coli biofilms were grown on PMMA coupons with a smooth surface (n = 5 per condition) or with deep crevices (n = 5 per condition) and on threaded screws, which were inserted into polymerizing PMMA (n = 5 per condition). PMMA coupons and PMMA-covered screws were subjected to 3 autoclave sterilization protocols. Colony-forming unit (CFU) counts and adenosine triphosphate (ATP) levels were measured to detect viable bacteria. Scanning electron microscope (SEM) images were obtained to determine whether biofilm was present.RESULTSNon-autoclaved PMMA surfaces were heavily contaminated, with values of 4.1 ± 2.3 × 106 CFUs/mL for S. aureus and 2.4 ± 1.2 × 106 CFUs/mL for E. coli. ATP levels of 3,230 ± 1,297 relative light units (RLU) for S. aureus and 1,006 ± 602 RLU for E. coli were observed. Crevices and screws were also heavily contaminated. Following autoclaving, CFUs/mL counts of <10 and RLU levels of <5 (beneath the hygienic threshold for cleanliness) were recorded on all PMMA surfaces, crevices, and screws. SEM confirmed that the biofilm structures remained intact, but they did not contain viable bacteria.CONCLUSIONSPMMA and PMMA-covered instruments contaminated with gram-positive or gram-negative biofilms are effectively sterilized using clinical autoclaving protocols.CLINICAL RELEVANCERetained PMMA and PMMA-covered surgical instruments that undergo a clinical autoclaving protocol do not carry viable bacteria.","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146033780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Complex Origins of Expectations in TKA: Commentary on an article by Carol A. Mancuso, MD, et al.: \"Sources of Patients' Expectations of Total Knee Arthroplasty\".","authors":"Cody C Wyles","doi":"10.2106/jbjs.25.01096","DOIUrl":"https://doi.org/10.2106/jbjs.25.01096","url":null,"abstract":"","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"6 1","pages":"79-80"},"PeriodicalIF":0.0,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-21DOI: 10.2106/jbjs.er.24.00248
Tomoyuki Kamenaga,Kenichi Kikuchi,Regis J O'Keefe,John C Clohisy,Cecilia Pascual-Garrido
{"title":"Erratum: Experimentally Induced Femoroacetabular Impingement Results in Hip Osteoarthritis.","authors":"Tomoyuki Kamenaga,Kenichi Kikuchi,Regis J O'Keefe,John C Clohisy,Cecilia Pascual-Garrido","doi":"10.2106/jbjs.er.24.00248","DOIUrl":"https://doi.org/10.2106/jbjs.er.24.00248","url":null,"abstract":"","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"266 1","pages":"e1"},"PeriodicalIF":0.0,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Antioxidant-Loaded Highly Cross-Linked Polyethylene in Total Knee Arthroplasty: The Need for Radiostereometric Randomized Controlled Trials: Commentary on an article by Heather A. Prentice, PhD, et al.: \"Antioxidant-Loaded Highly Cross-Linked Polyethylene May Reduce Revision Risk in Total Knee Arthroplasty. A U.S.-Based Cohort Study\".","authors":"B G Pijls","doi":"10.2106/jbjs.25.01312","DOIUrl":"https://doi.org/10.2106/jbjs.25.01312","url":null,"abstract":"","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"65 1","pages":"81-82"},"PeriodicalIF":0.0,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Development of Contiguous-Joint Arthritis After Pilon Fracture: Commentary on an article by Raveena Joshi, BS, et al.: \"The Prevalence of Subtalar Arthritis Following Pilon Fractures\".","authors":"Sheldon S Lin","doi":"10.2106/jbjs.25.01361","DOIUrl":"https://doi.org/10.2106/jbjs.25.01361","url":null,"abstract":"","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"48 1","pages":"75-76"},"PeriodicalIF":0.0,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Should a Course of Oral Corticosteroids Be Used Routinely After TKA?: Commentary on an article by Supakit Kanitnate, MD, et al.: \"Oral Corticosteroids Reduce Pain After Total Knee Arthroplasty: A Higher Dose of Dexamethasone Effectively Controlled Pain During Motion. A Dose-Response Randomized Placebo-Controlled Trial\".","authors":"Elizabeth B Gausden,Brian P Chalmers","doi":"10.2106/jbjs.25.01083","DOIUrl":"https://doi.org/10.2106/jbjs.25.01083","url":null,"abstract":"","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"187 1","pages":"77-78"},"PeriodicalIF":0.0,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
治疗性IV级。参见作者说明获得证据级别的完整描述。
{"title":"Assessment of Custom-Made Acetabular Implants for Complex Revision Total Hip Arthroplasty: A Concise Follow-up, at a Minimum of 5 Years.","authors":"Anna Di Laura,Johann Henckel,Alister Hart","doi":"10.2106/jbjs.25.00876","DOIUrl":"https://doi.org/10.2106/jbjs.25.00876","url":null,"abstract":"Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bryan Yijia Tan,Julia Poh Hwee Ng,Lincoln Ming Han Liow,Wei Seong Toh,Michael Gui Jie Yam,Joyce Bee Suang Koh,James Hui Po Hui
Orthopaedic surgeons are the custodians of the musculoskeletal system in Singapore, with >350 orthopaedic surgeons looking after the whole continuum of musculoskeletal disease in a population of 6 million. Orthopaedic research in Singapore currently has 4 focus areas: tissue engineering, biomechanics, clinical registries and cohorts, and population health and health services research. We have identified 4 key enablers of the continued development of orthopaedic research: talent development and academic clinical programs; shared data infrastructure, national cohorts, and artificial intelligence; innovation; and interdisciplinary, industry, and international collaboration. This is an exciting time for orthopaedic research in Singapore, where we find ourselves at the cusp of a new wave of talent, ideas, and resources. We stand ready and excited to partner with the world to advance musculoskeletal care globally.
{"title":"Orthopaedic Research in Singapore: The Past, Present, and Future.","authors":"Bryan Yijia Tan,Julia Poh Hwee Ng,Lincoln Ming Han Liow,Wei Seong Toh,Michael Gui Jie Yam,Joyce Bee Suang Koh,James Hui Po Hui","doi":"10.2106/jbjs.25.01276","DOIUrl":"https://doi.org/10.2106/jbjs.25.01276","url":null,"abstract":"Orthopaedic surgeons are the custodians of the musculoskeletal system in Singapore, with >350 orthopaedic surgeons looking after the whole continuum of musculoskeletal disease in a population of 6 million. Orthopaedic research in Singapore currently has 4 focus areas: tissue engineering, biomechanics, clinical registries and cohorts, and population health and health services research. We have identified 4 key enablers of the continued development of orthopaedic research: talent development and academic clinical programs; shared data infrastructure, national cohorts, and artificial intelligence; innovation; and interdisciplinary, industry, and international collaboration. This is an exciting time for orthopaedic research in Singapore, where we find ourselves at the cusp of a new wave of talent, ideas, and resources. We stand ready and excited to partner with the world to advance musculoskeletal care globally.","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"397 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145937661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Recurrently Back to the Drawing Board on Thromboprophylaxis After Spine Surgery: Commentary on an article by Ahmad Essa, MD, MPH, et al.: \"Trends and Impact of Pharmacological VTE Prophylaxis Timing for Traumatic Cervical Spinal Cord Injury Across North American Trauma Centers\".","authors":"Sarkis Sam Kaspar","doi":"10.2106/jbjs.25.01041","DOIUrl":"https://doi.org/10.2106/jbjs.25.01041","url":null,"abstract":"","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"39 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145907826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluating the Wear of a Viscoelastic Spinal Disc in the Context of Hip and Knee Arthroplasties: Commentary on an article by Kingsley R. Chin, MD, et al.: \"Comparative in Vitro Analysis of Wear Particles Generated by a Viscoelastic Disc Versus 2 Articulating Total Disc Replacements\".","authors":"Harry A McKellop","doi":"10.2106/jbjs.25.01201","DOIUrl":"https://doi.org/10.2106/jbjs.25.01201","url":null,"abstract":"","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"24 1","pages":"4-5"},"PeriodicalIF":0.0,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145907807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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