The Role of Body Mass Index and Hypoalbuminemia on Postoperative Outcomes in Patients Undergoing Total Knee Arthroplasty


Obesity and malnutrition are modifiable risk factors associated with increased postoperative complications following total knee arthroplasty (TKA). Obesity is paradoxically associated with malnutrition. Previous studies have only evaluated the impact of body mass index (BMI) and hypoalbuminemia separately in relation to postoperative TKA outcomes and have attempted to compare the impact of these modifiable risk factors. Our study seeks to establish if increased BMI and decreased albumin levels have a compounding effect on postoperative outcomes. A retrospective analysis was conducted using the 2011–2014 American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) dataset. This study reaffirmed that increased BMI and low albumin levels are associated with increased postoperative complications following TKA. Moreover, this study demonstrated that they do not have a compounding effect, but rather only help predict outcomes when analyzed individually. (Journal of Surgical Orthopaedic Advances 32(2) 114–117, 2023)

Key word: body mass index (BMI), total knee arthroplasty, obesity, hypoalbuminemia, postoperative outcomes

Alexis Gaskin, MD; Rolanda Willacy, MD; Regan Burgess; Kyra Caldwell; Olubode A. Olufajo, MD; and Shelton McKenzie, MD