At the recent Knee Society meeting in Orlando, Florida on March 5, 2016, Richard Iorio, MD, reviewed modifiable risk factors that are associated with poor clinical outcomes following hip and knee replacement. These included morbid obesity, poorly controlled diabetes and malnutrition, STAF colonization, cardiovascular disease, history of deep venous thrombosis, tobacco use, and psychological and behavioral problems including drug or alcohol dependency. These modifiable risk factors significantly account for avoidable complications and poor outcomes following knee replacement.
The prospect of undergoing a joint replacement provides an opportunity, a “teachable movement,” to identify and manage many of these risk factors. By implementing risk factor optimization programs, complication rates after joint replacement can be realized. In part of the shared decision-making model becoming more popular, it requires the physician to help the patient identify these risk factors and the patient to participate in programs and behavior to positively affect these outcomes. With the evolving evolution of value-oriented healthcare, the importance of the patient helping to optimize themselves for surgery cannot be underestimated.