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For procedures in which complications are catastrophic, including TJA, counseling should prioritize discontinuation of nonessential injectable biologics before surgery, explicit documentation of exposure, and heightened vigilance for early wound complications

Unopened lyophilized powder is more forgiving and can tolerate brief room-temperature periods, but a reconstituted vial needs consistent refrigeration and should be used within 28 days, the window supported by bacteriostatic water's antimicrobial preservative

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