What question did this study set out to answer?

This research aims to evaluate the impact of frailty on outcomes following total knee arthroplasty (TKA) using the modified frailty index.

February 14, 2026The Journal of Arthroplasty2 citationsOpen Access

Impact of Frailty on Total Knee Arthroplasty Outcomes: A Propensity-Matched Study of 133,264 Patients Using the Modified Frailty Index

STSri TummalaBaylor University Medical Center MMMehul MittalNorthwestern University SSSenthil SambandamSouthwestern Medical Center

Key Points

This research aims to evaluate the impact of frailty on outcomes following total knee arthroplasty (TKA) using the modified frailty index.
Utilized a propensity-matched design involving 133,264 patients
Employed the modified frailty index (mFI-5) for stratification
Assessed morbidity, mortality, and healthcare usage over 90-day, 2-year, and 5-year periods.
Identified a dose-dependent relationship between frailty severity and adverse outcomes
Moderate and severe frailty predicted higher morbidity and mortality
Found increased healthcare use among frail TKA patients over time.

Abstract

The mFI-5 effectively stratifies TKA patients by frailty severity and reveals a dose-dependent relationship with adverse outcomes. Moderate and severe frailty independently predict increased 90-day, 2-year, and 5-year morbidity, mortality, and healthcare use. Integrating mFI-5 into preoperative assessment may benefit orthopaedic surgeons in targeted optimization and counseling to mitigate risks in high-risk TKA patients.

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