Frailty Among Total Hip and Knee Arthroplasty Recipients: Epidemiology and Propensity Score-Weighted Analysis of Effect on In-Hospital Postoperative Outcomes

Abstract

1 in their article, "Frailty Among Total Hip and Knee Arthroplasty Recipients: Epidemiology and Propensity Score-weighted Analysis of Effect on In-hospital Postoperative Outcomes," reported that compared with a control group, "frail patients were found to have increased risk of any postoperative complication." In addition, frail patients had a longer length of stay. Frail patients were identified based on comorbidities, including muscle weakness, debility, muscle wasting, and disuse atrophy. Exactly how to screen for or determine the presence of these comorbidities was not made explicit. However, there is a readily available tool, easy to use, with predictive value that can identify frail patients before they undergo surgery and, by doing so, can facilitate optimization of care and hopefully reduce complications and improve outcomes. That tool is the Jamar Dynamometer. Long et al 2 in a prospective study of clinical outcomes after total hip arthroplasty identified low grip strength as a modifiable notable risk factor of increased length of stay, 90-day postoperative complications, worse functional results, and hospital readmissions. Van Diemen et al 3 in a review of patients undergoing total knee arthroplasty showed that higher grip strength was correlated with a faster recovery.Handgrip strength is one of the major factors for the diagnosis of sarcopenia. 4 Sarcopenia has been identified as a risk factor of prosthetic infection after total hip or total knee arthroplasty. 5 Be sure to measure grip strength; it is easy to do; and it provides useful information. Normative reference values are readily available. 6