Team Approach: Nutritional Assessment and Interventions in Elective Hip and Knee Arthroplasty
Ahmed K Emara1, Matthew J Hadad1, Michael Dube1,2
1Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio.
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Nutritional assessment is a critical element of routine preoperative assessment and should be approached by an interdisciplinary team that involves the primary care physician, dietitian, and orthopaedist.
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Patients should be stratified on the basis of their nutritional risk, which influences downstream optimization and deficiency reversal.
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The scientific literature indicates that nutritional supplementation affords protection against adverse outcomes and helps functional recovery, even among patients who are not at nutritional risk.
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Published investigations recommend a sufficient preoperative interval (at least 4 weeks) to ensure an adequate nutritional intervention in malnourished patients as opposed to regarding them as nonsurgical candidates.
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