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The pandemic of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), also named as novel coronavirus-2019 (COVID-19), has rapidly become one of the most significant socioeconomic and medical events in the modern human history. [1,2] It is widely acknowledged that lockdown, social distancing, and attention to hand hygiene have led to a reduction in the number of cases. [3][4][5] However, despite these measures, healthcare institutions across the Europe and North America were at risk of being overwhelmed by the large numbers of patients requiring respiratory support, as well as the need for isolation of the infected patients. [6] Objectives: This study aims to investigate the effectiveness of a screening questionnaire to identify high-risk patients for novel coronavirus-2019 (COVID-19) among those undergoing elective orthopedic surgery.Patients and methods: Between May 4 th , 2020 and June 11 th , 2020, a total of 1,021 consecutive patients (492 males, 529 females; mean age: 62.3±15.1 years; range, 13 to 91 years) who were scheduled for elective orthopedic surgery were included. A screening questionnaire was applied to all patients. The patients admitted to hospital were also tested for COVID-19 infection through reverse transcription-polymerase chain reaction of the nasopharyngeal swab.Results: Of the patients, 1,003 (98.2%) underwent elective surgery as planned. The screening questionnaire classified 30 patients as high-risk for COVID-19. A total of 18 procedures (n=18, 1.8%) were postponed due to the high risk of possible transmission of COVID-19. None of 991 low-risk patients were tested positive for COVID-19. Conclusion:The use of guiding principles for resuming elective orthopedic surgery is safe without a higher risk for complications in selected cases.

Aims One-stage exchange for periprosthetic joint infection (PJI) in total hip arthroplasty (THA) is gaining popularity. The outcome for a repeat one-stage revision THA after a failed one-stage exchange for infection remains unknown. The aim of this study was to report the infection-free and all-cause revision-free survival of repeat one-stage exchange, and to investigate the association between the Musculoskeletal Infection Society (MSIS) staging system and further infection-related failure. Methods We retrospectively reviewed all repeat one-stage revision THAs performed after failed one-stage exchange THA for infection between January 2008 and December 2016. The final cohort included 32 patients. The mean follow-up after repeat one-stage exchange was 5.3 years (1.2 to 13.0). The patients with a further infection-related failure and/or all-cause revision were reported, and Kaplan-Meier survival for these endpoints determined. Patients were categorized according to the MSIS system, and its association with further infection was analyzed. Results A total of eight repeat septic revisions (25%) developed a further infection-related failure, and the five-year infection-free survival was 81% (95% confidence interval (CI) 57 to 92). Nine (28%) underwent a further all-cause revision and the five-year all-cause revision-free survival was 74% (95% CI 52 to 88). Neither the MSIS classification of the host status (p = 0.423) nor the limb status (p = 0.366) was significantly associated with further infection-related failure. Conclusion Repeat one-stage exchange for PJI in THA is associated with a favourable five-year infection-free and all-cause revision-free survival. Notably, the rate of infection control is encouraging when compared with the reported rates after repeat two-stage exchange. The results can be used to counsel patients and help clinicians make informed decisions about treatment. With the available number of patients, further infection-related failure was not associated with the MSIS host or limb status. Cite this article: Bone Joint J 2022;104-B(1):27–33.

Total joint arthroplasty (TJA) is a treatment option that has been increasingly preferred in conditions which lead to joint damage such as severe osteoarthritis (OA), rheumatoid arthritis or avascular necrosis (AVN). [1][2][3] Patients with conditions that particularly affect the hip and knee joint experience a considerably impaired quality of life (QoL), [4][5][6] in which two main TJAs, i.e., total hip arthroplasty (THA) and total knee arthroplasty (TKA) are frequently preferred in the treatment of such patients. The number of primary and revision THAs and TKAs performed has been rising each day due to the expanding population and prolonged life span. [3,7,8] In the past, surgeons were not eager to perform such QoL procedures in patients with immune deficiency diseases due to the surgical risks involvedObjectives: This study aims to analyze the in-hospital complication rates in patients with human immunodeficiency virus (HIV) following primary total knee (TKA) and total hip arthroplasty (THA). Patients and methods:This retrospective study included a total of 37 patients including 11 patients undergoing TKA (11 males; mean age: 60.8±16.0 years; range, 48 to 80 years) and 26 patients undergoing THA (23 males, 3 females; mean age: 49.9±11.5 years; range, 35 to 70 years) between January 2010 and December 2019. The patients were evaluated in terms of body mass index (BMI), American Society of Anesthesiology (ASA) scores, preand postoperative blood tests, indications for surgery, operative time, length of hospital stay, and in-hospital complications. Results:The overall in-hospital complication rate following primary TKA (n=2, 18.2%) and THA (n=2, 7.7%) was 10.8%. Following TKA, one patient had deep vein thrombosis and one patient developed acute renal failure. In the THA group, postoperative delirium and trochanteric fracture were noted. Conclusion:The in-hospital complication rates increased in HIV-positive patients following TKA and THA. The risk of complications can be mitigated with the aid of a better interdisciplinary cooperation and thorough surgical planning.