Modifiable Risk Factors in Total Joint Arthroplasty: A Pilot Study

Area of Science:

• Orthopedic surgery
• Patient risk stratification

Background:

• Morbid obesity, smoking, and uncontrolled diabetes mellitus are linked to poor outcomes in total joint arthroplasty.
• No studies have reported on risk reduction strategies for these patients.

Purpose of the Study:

• To evaluate the effectiveness of a risk reduction strategy in patients undergoing total joint arthroplasty.
• To determine patient willingness and ability to modify risk factors before surgery.

Main Methods:

• Retrospective pilot review of a 3-month period implementing a risk reduction protocol.
• Risk factors defined as Body Mass Index (BMI) >40, Hemoglobin A1c (HbA1c) >8.0, and tobacco use.
• Outcomes evaluated in the subsequent 3-month period for 19 patients.

Main Results:

• 65.5% of at-risk patients followed the protocol.
• 57.9% improved their risk factors.
• 42.1% met surgical goals, with 21% undergoing joint replacement.

Conclusions:

• A significant proportion of patients are willing and able to modify pre-operative risk factors.
• Risk reduction strategies may improve surgical candidacy and outcomes for total joint arthroplasty patients.