Buller LT, et al. - Researchers presumed that hypothyroidism was associated with a higher risk of postoperative complications and 90-day costs following primary total knee arthroplasty (TKA). In order to test the validity of this notion, they queried Medicare standard analytical files and found that among patients with hypothyroidism, who underwent primary TKA, there was an increased risk of multiple postoperative complications and higher costs. Patients should be counseled by surgeons on these findings and should receive preoperative optimization strategies aimed at attenuating these risks and lower costs.