Cornell E, Novikov D, Niu R, et al. - Given an increased risk of complications after total joint arthroplasty (TJA) among patients with hepatitis C virus (HCV) infection and a growing body of evidence suggesting the benefit of preoperative antiviral treatment to decrease complications after TJA, researchers here examined the effect of preoperative antiviral treatment among those with advanced disease as indicated by hepatic fibrosis. Among 270 reviewed patients, 129 received antiviral treatment prior to TJA, whereas 141 did not. Outcomes revealed reduced postoperative complications after primary TJA in correlation with obtaining HCV antiviral treatment; this correlation was noted even among those who have progressed to hepatic fibrosis. This information can be used by surgeons in shared-decision making prior to TJA to counsel patients concerning the advantages of preoperative antiviral treatment even in the presence of hepatic fibrosis.