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

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