Total hip and knee arthroplasty are common surgical procedures aimed at improving mobility and quality of life. Despite surgical advances, postoperative complications remain a concern, particularly for patients with comorbidities and poor nutritional status. Immunonutrition, the targeted administration of nutrients that modulate inflammation, such as arginine, omega-3 fatty acids, and antioxidants, has been shown to reduce infections, complications in wound healing, and shorten hospital length of stay. This review examines current evidence on the role of immunonutrition in hip and knee arthroplasty, focusing on the mechanisms of key nutrients, clinical application of supplementation, and areas for future investigation. Despite promising outcomes, further research is needed within orthopedics to establish guidelines for patient screening, nutrient dosage, and timing of administration.

Current surgical literature on wound healing often excludes immunosuppressed individuals, such as those with HIV, due to their clinical complexity. Underlying disease processes can negatively influence perioperative outcomes through prolonged wound healing and increased infection risk. This review summarises factors that influence wound healing in patients with HIV undergoing orthopaedic surgery and highlights literature gaps in HIV-specific outcomes that inform intervention timing, duration, and surveillance.

Background: Axillary reverse mapping (ARM) and immediate lymphatic reconstruction (ILR) are both prophylactic surgical options to prevent breast cancer related lymphedema (BRCL) but have yet to be compared in published literature. Objectives: This systematic review and meta-analysis aims to summarize prospective studies evaluating the efficacy of ARM compared to ILR in reducing BRCL incidence. Methods: A comprehensive search of multiple databases was conducted from inception until January 2026. We selected prospective studies of breast cancer patients (>18yrs) undergoing axillary lymph node dissection (ALND) with at least 12 months of follow-up. Primary outcomes included the relative risk (RR) for lymphedema incidence in patients in the intervention group (ARM or ILR) compared to an ALND-only group. Results: Twelve studies (ARM = 7; ILR= 5) including 2,955 breast cancer patients met our inclusion criteria with average follow-up ranging from 14.8 to 44.6 months. A 67% reduction in lymphedema risk was observed in ARM patients (RR 0.33, 95% CI 0.19–0.56) compared to a 57% risk reduction for ILR recipients (RR 0.43, 95% CI 0.30–0.62). Discussion: The findings showed both ARM and ILR were more effective in reducing lymphedema development risk compared to ALND alone. ARM demonstrated a greater relative risk reduction than ILR, but indirect comparison of pooled estimates limits definitive conclusions on efficacy in comparison to one another. These findings highlight the need for direct ARM and ILR comparison studies to guide patient counseling, risk stratification, and surgical decision making.

Cartilage regeneration remains a major clinical challenge because cartilage has limited healing capacity and must withstand substantial mechanical loading. Silk fibroin, a cocoon-derived biomaterial with tunable mechanical properties, has emerged as a promising scaffold material for cartilage tissue engineering. This systematic review evaluates the biomechanical performance, fabrication approaches, and regenerative potential of silk fibroin bioprinted scaffolds for cartilage repair. A systematic review was conducted according to PRISMA guidelines. Primary outcomes included scaffold mechanical properties relevant to cartilage function. Secondary outcomes included scaffold composition, fabrication methods, biological performance, clinical applications, and reported limitations. Of 918 identified records, 24 studies published between 2014 and 2025 met the inclusion criteria. Most were preclinical studies using silk fibroin-based hydrogels, often combined with hyaluronic acid, gelatin, collagen, or synthetic polymers. Mechanical properties varied according to scaffold composition and crosslinking methods. Reinforced scaffolds generally demonstrated improved stiffness, structural support, and load distribution. Silk fibroin scaffolds consistently supported chondrogenesis and cartilage-like tissue formation. However, challenges remain, including mechanical mismatch with native cartilage, construct instability, cell loss, and suboptimal degradation profiles. Overall, silk fibroin bioprinted scaffolds demonstrated support for chondrogenesis and cartilage-like tissue formation in preclinical studies for cartilage regeneration. Future research should focus on standardized biomechanical testing, long-term in vivo evaluation, and clinically relevant scaffold designs to facilitate translation toward functional cartilage repair.