The Cost of Malnutrition in Total Joint Arthroplasty

The Geriatric Nutritional Risk Index Is an Independent Predictor of Adverse Outcomes for Total Joint Arthroplasty Patients

“…Malnutrition is determined using several methods, including serologic laboratory markers and anthropometric measurements. Although there is currently no gold standard on screening and assessing malnutrition in a patient before TJA, previous studies have evaluated albumin as an effective predictor tool [11,21,22]. This study adds further to the literature by suggesting GNRI as a malnourishment screening tool for patients undergoing TJA.…”

Recommendations from the ICM-VTE: General

“…More recently, VTE prophylaxis after elective hip and knee arthroplasty has evolved with the introduction of direct-oral anticoagulants (DOAC) including direct thrombin inhibitors (dabigatran) and Factor Xa inhibitors (rivaroxaban, apixaban). Recent literature also discloses aspirin (ASA) as safe and effective in the prevention of VTE in selected patients [1300][1301][1302][1303] .…”

Preoperative Patient Optimization in Total Joint Arthroplasty—The Paradigm Shift from Preoperative Clearance: A Narrative Review

“…Multiple studies have highlighted the association between hypoalbuminemia and increased risk of complications in TJA. In studies using the NSQIP database, hypoalbuminemia has been found to be an independent predictor of postoperative mortality, surgical site infections, respiratory events, cardiac events, bleeding with need for transfusion, sepsis, PJI, readmission, reoperation, and increased length of stay in TJA patients [5,11,22]. A study of 819 TJA cases by Rao et al found that congestive heart failure, chronic kidney disease, pancreatic insufficiency, gastroesophageal reflux disease, osteoporosis, and dementia were associated with abnormal preoperative albumin; Parkinson disease was associated with abnormal transferrin; and dementia, BMI, and cancer history were associated with abnormal TLC, suggesting that these laboratory tests may be most warranted in patients with these comorbidities [65].…”