Geriatric Nutritional Risk Index is a risk factor for long‐term decreases in patient‐reported outcome measures following total knee arthroplasty

Abstract Purpose Total knee arthroplasty (TKA) is an effective treatment for alleviating pain and improving function in patients with end‐stage knee osteoarthritis. However, factors influencing long‐term patient‐reported outcome measures (PROMs) remain underexplored. This study aimed to evaluate the...

Full description

Saved in:
Bibliographic Details
Main Authors: Yasuhiko Kokubu, Shinya Kawahara, Satoshi Hamai, Yukio Akasaki, Taishi Sato, Toshiki Konishi, Takahiro Inoue, Yasuharu Nakashima
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Journal of Experimental Orthopaedics
Subjects:
Online Access:https://doi.org/10.1002/jeo2.70170
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849716117825650688
author Yasuhiko Kokubu
Shinya Kawahara
Satoshi Hamai
Yukio Akasaki
Taishi Sato
Toshiki Konishi
Takahiro Inoue
Yasuharu Nakashima
author_facet Yasuhiko Kokubu
Shinya Kawahara
Satoshi Hamai
Yukio Akasaki
Taishi Sato
Toshiki Konishi
Takahiro Inoue
Yasuharu Nakashima
author_sort Yasuhiko Kokubu
collection DOAJ
description Abstract Purpose Total knee arthroplasty (TKA) is an effective treatment for alleviating pain and improving function in patients with end‐stage knee osteoarthritis. However, factors influencing long‐term patient‐reported outcome measures (PROMs) remain underexplored. This study aimed to evaluate the relationship between preoperative nutritional status, specifically the Geriatric Nutritional Risk Index (GNRI), and the long‐term decline in PROMs following TKA. Methods We conducted a retrospective cohort study including patients who underwent TKA between 2000 and 2009. PROMs were assessed using the Knee Society Score (KSS) at two time points: an initial evaluation in 2012 (median postoperative 4 years) and a follow‐up in 2023 (median 13 years). Preoperative GNRI, body mass index (BMI), and other demographic and clinical data were collected from medical records. Statistical analysis included paired t‐tests and multivariate logistic regression to identify independent risk factors for long‐term decline in KSS scores. Results A total of 75 patients completed follow‐up assessments. Over the 11‐year follow‐up period, there was a significant decrease in the KSS functional activity scores (p < 0.001), with 47 patients experiencing a decline exceeding the minimal clinically important difference. A multivariate analysis revealed low preoperative GNRI (p = 0.0043) as a significant risk factor for long‐term decline in PROMs. Conclusion Preoperative malnutrition, as indicated by a low GNRI, is a significant risk factor for long‐term decline in functional outcomes following TKA. These findings highlight the importance of preoperative nutritional interventions and rehabilitation for improving the long‐term outcomes of patients undergoing TKA. Level of Evidence Level III, retrospective cohort study.
format Article
id doaj-art-e4a0cebdbe6446cfbcd7c21c292f65c2
institution DOAJ
issn 2197-1153
language English
publishDate 2025-01-01
publisher Wiley
record_format Article
series Journal of Experimental Orthopaedics
spelling doaj-art-e4a0cebdbe6446cfbcd7c21c292f65c22025-08-20T03:13:07ZengWileyJournal of Experimental Orthopaedics2197-11532025-01-01121n/an/a10.1002/jeo2.70170Geriatric Nutritional Risk Index is a risk factor for long‐term decreases in patient‐reported outcome measures following total knee arthroplastyYasuhiko Kokubu0Shinya Kawahara1Satoshi Hamai2Yukio Akasaki3Taishi Sato4Toshiki Konishi5Takahiro Inoue6Yasuharu Nakashima7Department of Orthopaedic Surgery, Graduate School of Medical Sciences Kyushu University Fukuoka JapanDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences Kyushu University Fukuoka JapanDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences Kyushu University Fukuoka JapanDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences Kyushu University Fukuoka JapanDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences Kyushu University Fukuoka JapanDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences Kyushu University Fukuoka JapanDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences Kyushu University Fukuoka JapanDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences Kyushu University Fukuoka JapanAbstract Purpose Total knee arthroplasty (TKA) is an effective treatment for alleviating pain and improving function in patients with end‐stage knee osteoarthritis. However, factors influencing long‐term patient‐reported outcome measures (PROMs) remain underexplored. This study aimed to evaluate the relationship between preoperative nutritional status, specifically the Geriatric Nutritional Risk Index (GNRI), and the long‐term decline in PROMs following TKA. Methods We conducted a retrospective cohort study including patients who underwent TKA between 2000 and 2009. PROMs were assessed using the Knee Society Score (KSS) at two time points: an initial evaluation in 2012 (median postoperative 4 years) and a follow‐up in 2023 (median 13 years). Preoperative GNRI, body mass index (BMI), and other demographic and clinical data were collected from medical records. Statistical analysis included paired t‐tests and multivariate logistic regression to identify independent risk factors for long‐term decline in KSS scores. Results A total of 75 patients completed follow‐up assessments. Over the 11‐year follow‐up period, there was a significant decrease in the KSS functional activity scores (p < 0.001), with 47 patients experiencing a decline exceeding the minimal clinically important difference. A multivariate analysis revealed low preoperative GNRI (p = 0.0043) as a significant risk factor for long‐term decline in PROMs. Conclusion Preoperative malnutrition, as indicated by a low GNRI, is a significant risk factor for long‐term decline in functional outcomes following TKA. These findings highlight the importance of preoperative nutritional interventions and rehabilitation for improving the long‐term outcomes of patients undergoing TKA. Level of Evidence Level III, retrospective cohort study.https://doi.org/10.1002/jeo2.70170geriatricGeriatric Nutritional Risk Indexpatient‐reported outcome measurespreoperative malnutritiontotal knee arthroplasty
spellingShingle Yasuhiko Kokubu
Shinya Kawahara
Satoshi Hamai
Yukio Akasaki
Taishi Sato
Toshiki Konishi
Takahiro Inoue
Yasuharu Nakashima
Geriatric Nutritional Risk Index is a risk factor for long‐term decreases in patient‐reported outcome measures following total knee arthroplasty
Journal of Experimental Orthopaedics
geriatric
Geriatric Nutritional Risk Index
patient‐reported outcome measures
preoperative malnutrition
total knee arthroplasty
title Geriatric Nutritional Risk Index is a risk factor for long‐term decreases in patient‐reported outcome measures following total knee arthroplasty
title_full Geriatric Nutritional Risk Index is a risk factor for long‐term decreases in patient‐reported outcome measures following total knee arthroplasty
title_fullStr Geriatric Nutritional Risk Index is a risk factor for long‐term decreases in patient‐reported outcome measures following total knee arthroplasty
title_full_unstemmed Geriatric Nutritional Risk Index is a risk factor for long‐term decreases in patient‐reported outcome measures following total knee arthroplasty
title_short Geriatric Nutritional Risk Index is a risk factor for long‐term decreases in patient‐reported outcome measures following total knee arthroplasty
title_sort geriatric nutritional risk index is a risk factor for long term decreases in patient reported outcome measures following total knee arthroplasty
topic geriatric
Geriatric Nutritional Risk Index
patient‐reported outcome measures
preoperative malnutrition
total knee arthroplasty
url https://doi.org/10.1002/jeo2.70170
work_keys_str_mv AT yasuhikokokubu geriatricnutritionalriskindexisariskfactorforlongtermdecreasesinpatientreportedoutcomemeasuresfollowingtotalkneearthroplasty
AT shinyakawahara geriatricnutritionalriskindexisariskfactorforlongtermdecreasesinpatientreportedoutcomemeasuresfollowingtotalkneearthroplasty
AT satoshihamai geriatricnutritionalriskindexisariskfactorforlongtermdecreasesinpatientreportedoutcomemeasuresfollowingtotalkneearthroplasty
AT yukioakasaki geriatricnutritionalriskindexisariskfactorforlongtermdecreasesinpatientreportedoutcomemeasuresfollowingtotalkneearthroplasty
AT taishisato geriatricnutritionalriskindexisariskfactorforlongtermdecreasesinpatientreportedoutcomemeasuresfollowingtotalkneearthroplasty
AT toshikikonishi geriatricnutritionalriskindexisariskfactorforlongtermdecreasesinpatientreportedoutcomemeasuresfollowingtotalkneearthroplasty
AT takahiroinoue geriatricnutritionalriskindexisariskfactorforlongtermdecreasesinpatientreportedoutcomemeasuresfollowingtotalkneearthroplasty
AT yasuharunakashima geriatricnutritionalriskindexisariskfactorforlongtermdecreasesinpatientreportedoutcomemeasuresfollowingtotalkneearthroplasty