Impact of malnutrition on postoperative outcomes in total knee arthroplasty: a comprehensive analysis

Introduction: Malnutrition has been shown to cause perioperative complications, which can be particularly detrimental following total knee arthroplasty (TKA). These complications can lead to increased morbidity, extended hospital stays, and significant financial burdens on both patients and healthcare systems. To evaluate the nutritional status and body mass index (BMI) of patients undergoing TKA and monitor them for complications immediately postoperatively, at one week, and three months after surgery. Methods: This prospective study included 88 patients who underwent TKA at government medical college Kozhikode, Kerala, India. Nutritional status was assessed using serum albumin, ferritin, haemoglobin, and BMI (body mass index) levels. Patients were followed up for three months postoperatively to identify any complications. Data analysis was conducted to determine the relationship between malnutrition and postoperative complications. Results: Of the 88 patients, 5 developed major wound complications, with 4 of these patients exhibiting hypoalbuminemia. Hypoalbuminemia was found to have a statistically significant association with major wound complications (p<0.001). Malnutrition was associated with higher rates of major wound complications, increased need for postoperative blood transfusions, and longer hospital stays. Conclusion: Identifying modifiable risk factors such as malnutrition in patients undergoing TKA is crucial for reducing the risk of postoperative complications, which can otherwise lead to disastrous outcomes. Preoperative optimization of nutritional status can significantly improve surgical outcomes and reduce complications.