Wang Q, et al. - In patients undergoing primary total joint arthroplasty (TJA), researchers studied the relationship between operative time and the risk of subsequent surgical site infection (SSI) and periprosthetic joint infection (PJI). For this investigation, 17,342 primary unilateral total knee arthroplasty and total hip arthroplasty performed at a single institution between 2005-2016 were retrospectively reviewed, with a minimum follow-up of 1 year. In order to identify the connection between operative time and the development of SSI within 90-days and PJI within 1-year, a multivariate logistic regression model was developed. They found that the 90-day SSI and 1-year PJI incidence was 1.2% and 0.8%. Findings revealed that each 20-minute increase in operative time was related to nearly a 25% increased risk of subsequent PJI in patients undergoing primary TJA. While maintaining safe operative practices that reduce unnecessary steps and wasted time in the operating room, surgeons pay close attention to this underappreciated risk factor.