Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Jul 10:14:21514593231188864.
doi: 10.1177/21514593231188864. eCollection 2023.

Frailty and Pre-Frailty in the Setting of Total Joint Arthroplasty: A Narrative Review

Adam Pearl  1 , Aya Ismail  2 , Tariq Alsadi  3 , Zachary Crespi  4 , Mohammad Daher  5 , Khaled Saleh  6
Affiliations
Review

Frailty and Pre-Frailty in the Setting of Total Joint Arthroplasty: A Narrative Review

Adam Pearl et al. Geriatr Orthop Surg Rehabil. .

Abstract

Background: Total joint arthroplasties are among the most common surgical procedures performed in the United States. Although numerous safeguards are in place to optimize patient health and safety pre-, intra-, and postoperatively, patient frailty is often incompletely assessed or not assessed at all. Frailty has been shown to increase rates of adverse events and length of stay. We discuss the impact of frailty on patient outcomes and healthcare economics as well as provide widely accepted models to assess frailty and their optimal usage.

Methods: Several databases were searched using the keywords "frailty," "TJA," "THA," "frailty index," "frailty assessment," and "frailty risk." A total of 45 articles were used in this literature review.

Results: It is estimated that nearly half of patients over the age of 85 meet criteria for frailty. Frailty in surgical patients has been shown to increase total costs as well as length of stay. Additionally, increased rates of numerous adverse events are associated with increased frailty.

Conclusions: The literature demonstrates that frailty poses increased risk of adverse events, increased length of stay, and increased cost. There are several models that accurately assess frailty and can feasibly be implemented into preoperative screening.

Keywords: THA; TJA; arthroplasty; frailty; frailty assessment; frailty index; frailty risk.

PubMed Disclaimer

Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Clinical models to assess frailty.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Sloan M, Premkumar A, Sheth NP. Projected volume of primary total joint arthroplasty in the U.S., 2014 to 2030. JBJS. 2018;100(17):1455-1460. - PubMed
    1. Proietti M, Cesari M. Frailty: What is it? Advances in Experimental Medicine and Biology. 2020;1216:1-7. DOI: 10.1007/978-3-030-33330-0_1 - DOI - PubMed
    1. Morley JE, Vellas B, van Kan GA, et al.Frailty consensus: A call to action. J Am Med Dir Assoc. 2013;14:392-397. DOI: 10.1016/j.jamda.2013.03.022 - DOI - PMC - PubMed
    1. Schmucker AM, Hupert N, Mandl LA. The impact of frailty on short-term outcomes after elective hip and knee arthroplasty in older adults: A systematic review. Geriatr Orthop Surg Rehabil. 2019;10:2151459319835109. DOI: 10.1177/2151459319835109 - DOI - PMC - PubMed
    1. Simpson K, Seamon B, Hand B, et al.Effect of frailty on resource use and cost for medicare patients. Journal of Comparative Effecrtiveness Research. 2018;7(8). - PMC - PubMed

LinkOut - more resources