All primary total knee replacement patients will undergo the surgical procedure per the surgeon's standard technique. Samples of tissue that is ordinarily removed and discarded as a part of the procedure will be sent to the pathology lab, where the pathologist will prepare and stain the tissue sample to assess for levels of a specific protein thought to be a marker for the likelihood of the soft tissues to form dense versus loose scar tissue. We will then follow each patient's postoperative course to determine if levels of the protein in question, alpha smooth muscle actin (ASMA) correlate with outcomes. Outcomes will include postoperative pain, range of motion, as well as patient-reported satisfaction and function scores.
PEPPER is a randomized study comparing the three most commonly used blood thinners in North America in patients who have elected to undergo primary or revision hip or knee joint replacement surgery. The blood thinners being compared are enteric coated aspirin plus air pump compression, low intensity warfarin, and rivaroxaban.