Reevaluating the Role of Routine Preoperative Abdominal Ultrasound in Total Knee Replacement: A Retrospective Observational Study

Background and Aim: Routine preoperative abdominal ultrasonography is occasionally included in the workup for elderly patients undergoing elective orthopedic procedures, especially total knee replacement (TKR). The justification often hinges on the assumption that advancing age increases the prevalence of asymptomatic intra-abdominal pathologies. However, the clinical utility and cost-effectiveness of such an approach remain unclear. Our aim was to find out if preoperative ultrasound plays an important role in TKR work-up. Materials and Methods: We retrospectively studied 100 age- and gender-matched TKR patients, of whom 48 underwent preoperative abdominal ultrasound, while 52 did not. Results: Our findings showed that only one significant pathology—liver cancer—was identified, which led to surgical cancelation. Other findings included asymptomatic gallstones in three patients and fatty liver in 14 patients. Conclusion: We argue that the efficacy of routine abdominal ultrasound in this context is limited and advocate for implementation of a more symptom-guided, individualized preoperative approach.