Key result
Poor preoperative nutrition linked to higher postoperative infections, readmissions, and mortality.
Why the study?
Preoperative nutritional status is a key modifiable risk factor influencing surgical outcomes in THA and TKA, motivating a synthesis of its association with postoperative complications.
Does poor preoperative nutritional status increase postoperative complications in patients undergoing primary THA or TKA?
Does poor preoperative nutritional status increase postoperative complications in patients undergoing primary THA or TKA?
Preoperative nutritional assessment is essential for perioperative risk stratification in THA and TKA, as poor nutritional status is associated with worse postoperative outcomes.
Preoperative nutrition assessment may reduce THA/TKA complications; leaves open need for RCTs to confirm benefit.
Background and Objectives: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are widely performed procedures with high success rates but relevant postoperative complications. Preoperative nutritional status is a key modifiable risk factor influencing surgical outcomes. This study aimed to map and synthesize the available evidence on the association between preoperative nutritional status and postoperative complications in patients undergoing primary THA or TKA. Materials and Methods: A scoping review was conducted following PRISMA-ScR guidelines. A comprehensive search was performed in PubMed, ScienceDirect, and Scopus, with the last update conducted in April 2026. Studies published between 2015 and 2026 in English and Spanish were included. Eligibility criteria followed the PCC framework. Randomized controlled trials and observational studies were included. Risk of bias was assessed using the Newcastle–Ottawa Scale for observational studies and the Cochrane Risk of Bias tool for randomized trials. Results: A total of 1126 records were identified, and 23 studies were included, comprising 447,852 patients. Nutritional status was mainly assessed using serum biomarkers, particularly albumin, followed by anthropometric measures, combined indices, and micronutrients. Poor nutritional status, especially hypoalbuminemia, vitamin D deficiency, and low BMI, was associated with higher rates of infectious complications, prolonged hospital stay, increased readmissions and mortality, and worse functional recovery. Conclusions: Preoperative nutritional assessment is essential for perioperative risk stratification in THA and TKA. Integrating biomarkers, indices, and targeted interventions may improve outcomes and reduce postoperative complications.
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Garay-Álvarez et al. (2026) conducted a review in Total hip arthroplasty (THA) and total knee arthroplasty (TKA) (n=447,852). Preoperative nutritional status assessment was evaluated on Postoperative complications. Poor preoperative nutritional status, especially hypoalbuminemia, vitamin D deficiency, and low BMI, was associated with higher rates of infectious complications, readmissions, and mortality.
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