TEAM APPROACH: NUTRITIONAL ASSESSMENT AND INTERVENTIONS IN ELECTIVE HIP AND KNEE ARTHROPLASTY

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. Patients should be stratified on the basis of their nutritional risk, which influences downstream optimization and deficiency reversal. 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. 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.