{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:59:56Z","timestamp":1785405596810,"version":"3.56.0"},"reference-count":36,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010628","name":"Universidad de La Sabana","doi-asserted-by":"crossref","award":["MED-116-2025"],"award-info":[{"award-number":["MED-116-2025"]}],"id":[{"id":"10.13039\/501100010628","id-type":"DOI","asserted-by":"crossref"}]},{"award":["MED-116-2025"],"award-info":[{"award-number":["MED-116-2025"]}],"id":[{"id":"https:\/\/ror.org\/02sqgkj21","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are widely performed procedures with high success rates but relevant postoperative complications. Preoperative nutritional status is a key modifiable risk factor influencing surgical outcomes. This study aimed to map and synthesize the available evidence on the association between preoperative nutritional status and postoperative complications in patients undergoing primary THA or TKA. Materials and Methods: A scoping review was conducted following PRISMA-ScR guidelines. A comprehensive search was performed in PubMed, ScienceDirect, and Scopus, with the last update conducted in April 2026. Studies published between 2015 and 2026 in English and Spanish were included. Eligibility criteria followed the PCC framework. Randomized controlled trials and observational studies were included. Risk of bias was assessed using the Newcastle\u2013Ottawa Scale for observational studies and the Cochrane Risk of Bias tool for randomized trials. Results: A total of 1126 records were identified, and 23 studies were included, comprising 447,852 patients. Nutritional status was mainly assessed using serum biomarkers, particularly albumin, followed by anthropometric measures, combined indices, and micronutrients. Poor nutritional status, especially hypoalbuminemia, vitamin D deficiency, and low BMI, was associated with higher rates of infectious complications, prolonged hospital stay, increased readmissions and mortality, and worse functional recovery. Conclusions: Preoperative nutritional assessment is essential for perioperative risk stratification in THA and TKA. Integrating biomarkers, indices, and targeted interventions may improve outcomes and reduce postoperative complications.<\/jats:p>","DOI":"10.3390\/medicina62050958","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T15:05:08Z","timestamp":1779721508000},"page":"958","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Preoperative Nutritional Status on Postoperative Outcomes of Total Hip and Knee Arthroplasty: A Scoping Review"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-6369-8177","authenticated-orcid":false,"given":"Mariana","family":"Garay-\u00c1lvarez","sequence":"first","affiliation":[{"name":"School of Medicine, Universidad de La Sabana, Ch\u00eda 250001, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9476-4292","authenticated-orcid":false,"given":"Juanita","family":"Fetecua-Chaparro","sequence":"additional","affiliation":[{"name":"School of Medicine, Universidad de La Sabana, Ch\u00eda 250001, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8686-2361","authenticated-orcid":false,"given":"Paula A.","family":"Rodr\u00edguez-Molina","sequence":"additional","affiliation":[{"name":"School of Medicine, Universidad de La Sabana, Ch\u00eda 250001, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9112-773X","authenticated-orcid":false,"given":"Giovanni","family":"Rodr\u00edguez-Rojas","sequence":"additional","affiliation":[{"name":"School of Medicine, Universidad de La Sabana, Ch\u00eda 250001, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabela","family":"\u00c1lvarez-Rivas","sequence":"additional","affiliation":[{"name":"School of Medicine, Universidad de La Sabana, Ch\u00eda 250001, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7243-2238","authenticated-orcid":false,"given":"Eduardo","family":"Tuta-Quintero","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Universidad de La Sabana, Ch\u00eda 250001, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"R\u00edos-Barbosa","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Universidad de La Sabana, Ch\u00eda 250001, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan G.","family":"Ortiz-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Universidad de La Sabana, Ch\u00eda 250001, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.arth.2015.08.028","article-title":"Hypoalbuminemia independently predicts surgical site infection, pneumonia, length of stay, and readmission after total joint arthroplasty","volume":"31","author":"Bohl","year":"2016","journal-title":"J. Arthroplast."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1016\/j.arth.2015.12.004","article-title":"Can serum albumin level and total lymphocyte count be surrogates for malnutrition to predict wound complications after total knee arthroplasty?","volume":"31","author":"Morey","year":"2016","journal-title":"J. Arthroplast."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e489","DOI":"10.3928\/01477447-20180424-04","article-title":"Preoperative vitamin D deficiency is associated with higher postoperative complication rates in total knee arthroplasty","volume":"41","author":"Hegde","year":"2018","journal-title":"Orthopedics"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.arth.2020.07.055","article-title":"Low body mass index is a predictor for mortality and increased length of stay following total joint arthroplasty","volume":"36","author":"Katakam","year":"2021","journal-title":"J. Arthroplast."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1007\/s10195-016-0414-y","article-title":"Association between low serum vitamin D levels and the length of hospital stay after arthroplasty","volume":"17","author":"Maier","year":"2016","journal-title":"J. Orthop. Traumatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1007\/s00264-020-04892-4","article-title":"Malnutrition as predictor of poor outcome after total hip arthroplasty","volume":"45","author":"Eminovic","year":"2021","journal-title":"Int. Orthop."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1002\/pmrj.12570","article-title":"Preoperative malnutrition is a risk factor for delayed recovery of mobilization after total hip arthroplasty","volume":"13","author":"Nanri","year":"2021","journal-title":"PM&R"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2594","DOI":"10.1016\/j.arth.2019.05.060","article-title":"The role of malnutrition in ninety-day outcomes after total joint arthroplasty","volume":"34","author":"Black","year":"2019","journal-title":"J. Arthroplast."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.endinu.2022.03.009","article-title":"Malnutrition is associated with postoperative complications in elderly patients undergoing total hip arthroplasty","volume":"70","year":"2023","journal-title":"Endocrinol. Diabetes Nutr."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2119","DOI":"10.11124\/JBIES-20-00167","article-title":"Updated methodological guidance for the conduct of scoping reviews","volume":"18","author":"Peters","year":"2020","journal-title":"JBI Evid. Synth."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA extension for Scoping Reviews (PRISMA-ScR): Checklist and explanation","volume":"169","author":"Tricco","year":"2018","journal-title":"Ann. Intern. Med."},{"key":"ref_12","unstructured":"Wells, G.A., Shea, B., O\u2019Connell, D., Peterson, J., Welch, V., Losos, M., and Tugwell, P. (2026, May 04). The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-Analyses. Available online: https:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp\/."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1186\/s13643-016-0384-4","article-title":"Rayyan\u2014A web and mobile app for systematic reviews","volume":"5","author":"Ouzzani","year":"2016","journal-title":"Syst. Rev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"117","DOI":"10.4103\/2231-0770.165122","article-title":"Nutritional status as a predictive marker for surgical site infection in total joint arthroplasty","volume":"5","author":"Alfargieny","year":"2015","journal-title":"Avicenna J. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1016\/j.arth.2015.12.053","article-title":"Assessing in-hospital outcomes and resource utilization after primary total joint arthroplasty among underweight patients","volume":"31","author":"Anoushiravani","year":"2016","journal-title":"J. Arthroplast."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2415","DOI":"10.1016\/j.arth.2016.04.032","article-title":"Malnutrition increases with obesity and is a stronger independent risk factor for postoperative complications","volume":"31","author":"Fu","year":"2016","journal-title":"J. Arthroplast."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1016\/j.jos.2020.07.019","article-title":"Prognostic nutritional index as a risk factor for aseptic wound complications after total knee arthroplasty","volume":"26","author":"Hanada","year":"2021","journal-title":"J. Orthop. Sci."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"S151","DOI":"10.1016\/j.arth.2024.05.012","article-title":"Effect of vitamin D deficiency on periprosthetic joint infection and complications after primary total joint arthroplasty","volume":"39","author":"Birinci","year":"2024","journal-title":"J. Arthroplast."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2117","DOI":"10.1016\/j.arth.2025.02.002","article-title":"Albumin as a predictor of periprosthetic joint infection following total joint arthroplasty: Identifying a new data-driven threshold utilizing a continuous variable analysis","volume":"40","author":"Telang","year":"2025","journal-title":"J. Arthroplast."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1177\/1120700018808704","article-title":"The serum albumin threshold for increased perioperative complications after total hip arthroplasty is 3.0 g\/dL","volume":"29","author":"Nelson","year":"2019","journal-title":"HIP Int."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1055\/s-0038-1672122","article-title":"Albumin, prealbumin, and transferrin may be predictive of wound complications following total knee arthroplasty","volume":"31","author":"Roche","year":"2018","journal-title":"J. Knee Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1587","DOI":"10.1007\/s00264-025-06518-z","article-title":"Impact of low body mass index on reoperation risk and complications after joint arthroplasty: A cohort study","volume":"49","author":"Ruangsomboon","year":"2025","journal-title":"Int. Orthop."},{"key":"ref_23","first-page":"664","article-title":"Vitamin D deficiency is associated with longer hospital stay and lower functional outcome after total knee arthroplasty","volume":"83","author":"Joris","year":"2017","journal-title":"Acta Orthop. Belg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1559","DOI":"10.1016\/j.arth.2023.02.008","article-title":"Underweight patients are at increased risk for complications following total hip arthroplasty","volume":"38","author":"McDonald","year":"2023","journal-title":"J. Arthroplast."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Briguglio, M., Latella, M., Sirtori, P., Mangiavini, L., De Luca, P., Geroldi, M., De Vecchi, E., Lombardi, G., Petrillo, S., and Wainwright, T.W. (2025). Influence of preoperative diagnosis of nutritional disorders on short-term outcomes after hip arthroplasty: A cohort study of older adults. Nutrients, 17.","DOI":"10.3390\/nu17142319"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"3390","DOI":"10.1016\/j.arth.2017.06.020","article-title":"Multimodal nutritional management in primary total knee arthroplasty: A randomized controlled trial","volume":"32","author":"Cao","year":"2017","journal-title":"J. Arthroplast."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1186\/s13063-017-2255-2","article-title":"Supplementation of vitamin D deficiency to improve outcomes after arthroplasty (VASO study)","volume":"18","author":"Morrison","year":"2017","journal-title":"Trials"},{"key":"ref_28","unstructured":"Higgins, J., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M., and Welch, V. (2026, May 04). Cochrane Handbook for Systematic Reviews of Interventions Version 6.0. Available online: https:\/\/training.cochrane.org\/handbook\/."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.jpra.2024.01.006","article-title":"Impact of nutrition on skin wound healing and aesthetic outcomes: A comprehensive narrative review","volume":"39","author":"Seth","year":"2024","journal-title":"JPRAS Open"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1186\/s13018-024-05165-1","article-title":"Association between malnutrition status and total joint arthroplasty periprosthetic joint infection and surgical site infection: A systematic review and meta-analysis","volume":"19","author":"Chen","year":"2024","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1016\/j.ajic.2025.08.015","article-title":"The impact of nutritional status on surgical site infection rates among total joint arthroplasty patients: A systematic review","volume":"53","author":"Gee","year":"2025","journal-title":"Am. J. Infect. Control."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1016\/j.arth.2019.11.018","article-title":"The cost of malnutrition in total joint arthroplasty","volume":"35","author":"Bala","year":"2020","journal-title":"J. Arthroplast."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1093\/bmb\/ldaa018","article-title":"Outcome of total hip and total knee arthroplasty and vitamin D homeostasis","volume":"135","author":"Brambilla","year":"2020","journal-title":"Br. Med. Bull."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.1016\/j.arth.2025.09.019","article-title":"The majority of total joint arthroplasty patients have hypovitaminosis D: An analysis from a single tertiary care center in China","volume":"41","author":"Zha","year":"2026","journal-title":"J. Arthroplast."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"S836","DOI":"10.1016\/j.arth.2022.01.049","article-title":"The Geriatric Nutritional Risk Index is an independent predictor of adverse outcomes for total joint arthroplasty patients","volume":"37","author":"Fang","year":"2022","journal-title":"J. Arthroplast."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1186\/1748-5908-5-69","article-title":"Scoping studies: Advancing the methodology","volume":"5","author":"Levac","year":"2010","journal-title":"Implement. Sci."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/5\/958\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T04:23:22Z","timestamp":1779769402000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/5\/958"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,14]]},"references-count":36,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["medicina62050958"],"URL":"https:\/\/doi.org\/10.3390\/medicina62050958","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,14]]}}}