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...
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| Format: | Article |
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Wiley
2025-01-01
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| Series: | Journal of Experimental Orthopaedics |
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| Online Access: | https://doi.org/10.1002/jeo2.70170 |
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| 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 |
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