Nutritional Assessment and Interventions in Elective Hip and Knee Arthroplasty: a Detailed Review and Guide to Management

Purpose of Review8.5 to 50% of total joint arthroplasty (TJA) patients are reported to have preoperative malnutrition. The narrative review identifies the relationship between preoperative malnutrition for TJA patients and postoperative outcomes as well as the use of perioperative nutritional intervention to improve postoperative complications.Recent FindingsBiochemical/laboratory, anthropometric, and clinical measures have been widely used to identify preoperative nutritional deficiency. Specifically, serum albumin is the most prevalent used marker in TJA because it has been proven to be correlated with protein-energy malnutrition due to the surgical stress response. However, there remains a sustained incidence of preoperative malnutrition in total knee arthroplasty (TKA) and total hip arthroplasty (THA) patients due to a lack of agreement among the available nutritional screening tools and utilization of isolated laboratory, anthropometric, and clinical variables. Previous investigations have also suggested preoperative malnutrition to be a prognostic indicator of complications in general, cardiac, vascular, and orthopaedic surgery specialties.SummarySerum albumin, prealbumin, transferrin, and total lymphocyte count (TLC) can be used to identify at-risk patients. It is important to employ these markers in the preoperative setting because malnourished TKA and THA patients have shown to have worse postoperative outcomes including prolonged length, increased reoperation rates, increased infection rates, and increased mortality rates. Although benefits from high-protein and high-anti-inflammatory diets have been exhibited, additional research is needed to confirm the use of perioperative nutritional intervention as an appropriate treatment for preoperative TJA patients.     

Ergebnisse allergologischer Untersuchungen bei den Säuglings-Ernährungsstörungen und verwandten Syndromen

Journal of Molecular Medicine -     

Einzelreferate und Buchbesprechungen

Ohne Zusammenfassung     

Wirkungen und Ausblicke der Lebertherapie bei Anaemia Perniciosa

Ohne ZusammenfassungNach einem Vortrag, gehalten am 6. Februar 1928 in der Sitzung des Vereins für Innere Medizin und Kinderheilkunde in Berlin.     

Hautkrankheiten

Ohne Zusammenfassung     

Geschlechtskrankheiten

Ohne Zusammenfassung     

Hautkrankheiten

Ohne Zusammenfassung