Preoperative frailty in patients undergoing total knee or hip arthroplasty affects FIM scores at one week postoperatively

AIM: Very few reports have investigated the association between frailty and postoperative outcomes in total knee arthroplasty (TKA) and total hip arthroplasty (THA), making the accumulation of evidence an urgent task. This study aimed to clarify the effect of preoperative frailty on short-term postoperative outcomes in patients undergoing TKA/THA. METHODS: This prospective cohort study, conducted from December 2023 to September 2024, included 19 patients (mean age±standard deviation, 73.8±7.2 years) scheduled for TKA/THA. Frailty was assessed preoperatively using the Questionnaire for Medical Checkup of Old-Old (QMCOO) and the Japanese version of the Cardiovascular Health Study (J-CHS) criteria, along with the Functional Independence Measure (FIM). FIM scores were also evaluated one week postoperatively. Postoperative FIM scores were compared based on frailty status. RESULTS: Of the 19 patients, 6 (31.6%) were classified as having frailty based on the QMCOO (score≥5) and 7 (36.8%) met the frailty criteria according to the J-CHS. With regard to the preoperative to postoperative FIM score change, the QMCOO≥5 group showed a significantly larger decline (-23.2±10.1 points, [median, -19.5]) in comparison to the QMCOO<5 group (-13.8±4.7 points, [median, -15.0]) (p=0.029). Similarly, patients classified as having frailty according to the J-CHS (-23.1±8.8 points, [median, -20.0]) experienced a greater FIM decline than the non-frailty (-13.1±4.4 points, [median, -13.5]) (p=0.004). Moreover, patients classified as frail according to J-CHS had lower FIM scores at one week postoperatively (p<0.001), with a significantly higher proportion of patients scoring < 110 points (p=0.017). CONCLUSIONS: Preoperative frailty may negatively affect short-term postoperative outcomes after TKA/THA.