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. 2024 Jun 25;14(1):14598.
doi: 10.1038/s41598-024-65719-5.

Age-adjusted 5-factor modified frailty index as a valuable tool for patient selection in bilateral simultaneous total knee arthroplasty

Yuichi Yamaguchi #  1 , Yosuke Matsumura #  1 , Masanori Fujii  2 , Shuya Ide  3 , Tatsuya Sakai  1 , Satomi Nagamine  1 , Shuichi Eto  4 , Takafumi Shimazaki  5 , Tomonori Tajima  6 , Masaaki Mawatari  1
Affiliations

Age-adjusted 5-factor modified frailty index as a valuable tool for patient selection in bilateral simultaneous total knee arthroplasty

Yuichi Yamaguchi et al. Sci Rep. .

Abstract

Although bilateral simultaneous total knee arthroplasty (BSTKA) is an effective treatment for bilateral knee osteoarthritis, safety concerns and lack of precise patient selection criteria persist. The purpose of this retrospective study was to determine the complication rate and the role of frailty in patient selection for BSTKA. We analyzed data from 434 patients who underwent BSTKA between February 2012 and January 2021, examining demographic factors and preoperative blood test results. Complications occurred in 77 patients (18%), with anemia requiring transfusion being the most common (26 patients, 5.9%). In the univariate analysis, age ≥ 75 years, age-adjusted Charlson Comorbidity Index ≥ 5, age-adjusted 5-factor modified Frailty Index (aamFI-5) ≥ 3, hemoglobin ≤ 11.0 g/dL, albumin ≤ 3.5 g/dL, estimated glomerular filtration rate < 45 ml/dl/1.73 m2, and D-dimer ≥ 2.0 μg/mL contributed to postoperative complications (p < 0.05). Multivariate analysis identified aamFI-5 ≥ 3 as an independent risk factor (p = 0.002). Our findings underscore the practical utility of aamFI-5 in predicting complications after BSTKA, providing valuable guidance to surgeons in the selection of BSTKA candidates and ultimately improving clinical outcomes.

Keywords: Bilateral simultaneous; Complications; Frailty index; Risk factor analysis; Total knee arthroplasty.

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Conflict of interest statement

The authors declare no competing interests.

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