{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T01:42:40Z","timestamp":1780105360351,"version":"3.54.0"},"reference-count":31,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T00:00:00Z","timestamp":1752451200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"public project \u201cRicerca Corrente\u201d of the Italian Ministry of Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Nutritional disorders may affect short-term recovery after major orthopaedic surgery, but evidence is lacking. This study assessed whether and how different nutritional disorders diagnosed at admission could influence early recovery after hip replacement. Methods: A prospective analytical study was designed to include 60 patients scheduled for elective primary hip replacement and assess their nutritional status to diagnose 5 malnutrition phenotypes: undernutrition, sarcopenia, obesity, sarcopenic obesity, and sarcopenic undernutrition. Outcome measures were 24 h change in neutrophils, 72 h change in haemoglobin, and 10-day gait speed regain. Results: Haemoglobin reached the nadir at day 2\u20133 and partially recovered by day 10 in all patients, with sarcopenia and undernutrition being the strongest predictors of the postoperative drop (\u22122.37 g\u2219dL\u22121 and \u22120.80 g\u2219dL\u22121, p &lt; 0.05). Neutrophils peaked immediately after surgery and returned to baseline levels at discharge, with sarcopenic undernutrition displaying a blunted response after surgery (\u221216.20%, p &lt; 0.01). Undernutrition was found to be the most influential preoperative variable on gait speed recovery, but with a marginal effect. None of the patients covered the reference energy and protein needs through diet in the 10 postoperative days. Conclusions: In this cohort, nutritional disorders with reduced body function and reserves (sarcopenia and undernutrition) grounded a greater vulnerability to surgery in terms of early stress response and short-term recovery. This calls for both advanced planning of nutritional prehabilitation strategies for these conditions and adequate postoperative nutritional support.<\/jats:p>","DOI":"10.3390\/nu17142319","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T08:04:41Z","timestamp":1752566681000},"page":"2319","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Influence of Preoperative Diagnosis of Nutritional Disorders on Short-Term Outcomes After Hip Arthroplasty: A Cohort Study of Older Adults"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0801-2359","authenticated-orcid":false,"given":"Matteo","family":"Briguglio","sequence":"first","affiliation":[{"name":"IRCCS Ospedale Galeazzi\u2014Sant\u2019Ambrogio, Laboratory of Nutritional Sciences, 20157 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7932-0602","authenticated-orcid":false,"given":"Marialetizia","family":"Latella","sequence":"additional","affiliation":[{"name":"IRCCS Ospedale Galeazzi\u2014Sant\u2019Ambrogio, Laboratory of Nutritional Sciences, 20157 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Sirtori","sequence":"additional","affiliation":[{"name":"IRCCS Ospedale Galeazzi\u2014Sant\u2019Ambrogio, EUORR Unit, 20157 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Mangiavini","sequence":"additional","affiliation":[{"name":"IRCCS Ospedale Galeazzi\u2014Sant\u2019Ambrogio, EUORR Unit, 20157 Milan, Italy"},{"name":"Department of Biomedical Sciences for Health, University \u201cLa Statale\u201d, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9810-8818","authenticated-orcid":false,"given":"Paola","family":"De Luca","sequence":"additional","affiliation":[{"name":"IRCCS Ospedale Galeazzi\u2014Sant\u2019Ambrogio, Laboratory of Biotechnology Applied to Orthopedics, 20157 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Geroldi","sequence":"additional","affiliation":[{"name":"IRCCS Ospedale Galeazzi\u2014Sant\u2019Ambrogio, EUORR Unit, 20157 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9781-8607","authenticated-orcid":false,"given":"Elena","family":"De Vecchi","sequence":"additional","affiliation":[{"name":"IRCCS Ospedale Galeazzi\u2014Sant\u2019Ambrogio, Laboratory of Clinical Chemistry and Microbiology, 20157 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8365-985X","authenticated-orcid":false,"given":"Giovanni","family":"Lombardi","sequence":"additional","affiliation":[{"name":"IRCCS Ospedale Galeazzi\u2014Sant\u2019Ambrogio, Laboratory of Experimental Biochemistry and Molecular Biology, 20157 Milan, Italy"},{"name":"Department of Athletics, Strength and Conditioning, Pozna\u0144 University of Physical Education, 61-871 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0843-2273","authenticated-orcid":false,"given":"Stefano","family":"Petrillo","sequence":"additional","affiliation":[{"name":"IRCCS Ospedale Galeazzi\u2014Sant\u2019Ambrogio, Prosthetic Surgery Centre, 20157 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7860-2990","authenticated-orcid":false,"given":"Thomas W.","family":"Wainwright","sequence":"additional","affiliation":[{"name":"Orthopaedic Research Institute, Bournemouth University, Bournemouth BH12 5BB, UK"},{"name":"NHS Foundation Trust, University Hospitals Dorset, Bournemouth BH7 7DW, UK"},{"name":"Rehabilitation Department, Lanzhou University, Lanzhou 730000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9341-7187","authenticated-orcid":false,"given":"Giuseppe M.","family":"Peretti","sequence":"additional","affiliation":[{"name":"IRCCS Ospedale Galeazzi\u2014Sant\u2019Ambrogio, EUORR Unit, 20157 Milan, Italy"},{"name":"Department of Biomedical Sciences for Health, University \u201cLa Statale\u201d, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9578-5338","authenticated-orcid":false,"given":"Giuseppe","family":"Banfi","sequence":"additional","affiliation":[{"name":"IRCCS Ospedale Galeazzi\u2014Sant\u2019Ambrogio, Scientific Direction, 20157 Milan, Italy"},{"name":"Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.clnu.2016.09.004","article-title":"ESPEN guidelines on definitions and terminology of clinical nutrition","volume":"36","author":"Cederholm","year":"2017","journal-title":"Clin. Nutr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.clnesp.2018.11.016","article-title":"Energy and protein intake in 330 geriatric orthopaedic patients: Are the current nutrition guidelines applicable?","volume":"29","author":"Rosenberger","year":"2019","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1002\/jcsm.12383","article-title":"GLIM criteria for the diagnosis of malnutrition\u2014A consensus report from the global clinical nutrition community","volume":"10","author":"Cederholm","year":"2019","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/ageing\/afy169","article-title":"Sarcopenia: Revised European consensus on definition and diagnosis","volume":"48","author":"Bahat","year":"2019","journal-title":"Age Ageing"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1159\/000521241","article-title":"Definition and Diagnostic Criteria for Sarcopenic Obesity: ESPEN and EASO Consensus Statement","volume":"15","author":"Donini","year":"2022","journal-title":"Obes. Facts"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Briguglio, M., Wainwright, T., and Lombardi, G. (2023). Definition of malnutrition from routinely-collected data for orthopedic surgery research: The global leadership initiative on malnutrition (GLIM) tool and others. Front. Nutr., 10.","DOI":"10.3389\/fnut.2023.1200049"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1326","DOI":"10.1016\/j.arth.2023.02.077","article-title":"Relationship between Preoperative Nutritional Status and Predicting Short-Term Complications Following Revision Total Hip Arthroplasty","volume":"38","author":"Heimroth","year":"2023","journal-title":"J. Arthroplast."},{"key":"ref_8","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 meta-analysis","volume":"19","author":"Chen","year":"2024","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Chiavarini, M., Ricciotti, G.M., Genga, A., Faggi, M.I., Rinaldi, A., Toscano, O.D., D\u2019Errico, M.M., and Barbadoro, P. (2024). Malnutrition-Related Health Outcomes in Older Adults with Hip Fractures: A Systematic Review and Meta-Analysis. Nutrients, 16.","DOI":"10.3390\/nu16071069"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"101192","DOI":"10.1016\/j.ijotn.2025.101192","article-title":"To lose weight or to weight the loss? Insights into the use of the body mass index in preoperative assessment before major orthopaedic surgery","volume":"58","author":"Briguglio","year":"2025","journal-title":"Int. J. Orthop. Trauma. Nurs."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.artd.2022.05.001","article-title":"Prevalence of Sarcopenia and Sarcopenic Obesity in an Academic Total Joint Arthroplasty Practice","volume":"16","author":"DeMik","year":"2022","journal-title":"Arthroplast. Today"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1302\/0301-620X.104B3.BJJ-2021-1052.R1","article-title":"The effect of sarcopenia on outcomes following orthopaedic surgery: A systematic review","volume":"104-B","author":"Brzeszczynski","year":"2022","journal-title":"Bone Jt. J."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Briguglio, M., Sirtori, P., Mangiavini, L., Buzzi, S., Cordani, C., Zerni, M.F., Wainwright, T.W., Ursino, N., Peretti, G.M., and Banfi, G. (2023). How Do Older Patients with End-Stage Osteoarthritis of the Hip Eat Prior to Hip Replacement? A Preliminary Snapshot that Highlights a Poor Diet. Nutrients, 15.","DOI":"10.3390\/nu15234868"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1097\/NOR.0000000000001058","article-title":"Undernutrition, sarcopenia, sarcopenic obesity, and sarcopenic undernutrition: A cross-sectional view on patients before total joint arthroplasty","volume":"43","author":"Briguglio","year":"2024","journal-title":"Orthop. Nurs."},{"key":"ref_15","first-page":"59","article-title":"Malnutrition is associated with postoperative complications in elderly patients undergoing total hip arthroplasty","volume":"70","year":"2023","journal-title":"Endocrinol. Diabetes Nutr. (Engl. Ed.)"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1080\/17453674.2016.1203477","article-title":"Does BMI influence hospital stay and morbidity after fast-track hip and knee arthroplasty?","volume":"87","author":"Husted","year":"2016","journal-title":"Acta Orthop."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Gillis, C., Hasil, L., Keane, C., Brassard, D., Kiernan, F., Bellafronte, N.T., Culos-Reed, S.N., Gramlich, L., Ljungqvist, O., and Fenton, T.R. (2025). A multimodal prehabilitation class for Enhanced Recovery after Surgery: A pragmatic randomised type 1 hybrid effectiveness-implementation trial. Br. J. Anaesth.","DOI":"10.1016\/j.bja.2025.03.001"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2481","DOI":"10.1001\/jama.297.22.2481","article-title":"Preoperative hematocrit levels and postoperative outcomes in older patients undergoing noncardiac surgery","volume":"297","author":"Wu","year":"2007","journal-title":"JAMA"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e1077","DOI":"10.5435\/JAAOS-D-18-00810","article-title":"Treating Preoperative Anemia to Improve Patient Outcomes after Orthopaedic Surgery","volume":"27","author":"Shanbhag","year":"2019","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"ref_20","first-page":"296","article-title":"Peri-operative treatment of anaemia in major orthopaedic surgery: A practical approach from Spain","volume":"15","author":"Bisbe","year":"2017","journal-title":"Blood Transfus."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1177\/014860717900300309","article-title":"Instant nutritional assessment","volume":"3","author":"Seltzer","year":"1979","journal-title":"JPEN J. Parenter. Enter. Nutr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1097\/AIA.0000000000000026","article-title":"Perioperative frailty","volume":"52","author":"Amrock","year":"2014","journal-title":"Int. Anesthesiol. Clin."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1097\/ALN.0000000000000795","article-title":"Promoting Perioperative Metabolic and Nutritional Care","volume":"123","author":"Gillis","year":"2015","journal-title":"Anesthesiology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.clnesp.2023.05.015","article-title":"Phase angle and body composition: A scoping review","volume":"56","author":"Martins","year":"2023","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"104009","DOI":"10.1016\/j.archger.2020.104009","article-title":"Body mass index and recovery of activities of daily living in older patients with femoral fracture: An analysis of a national inpatient database in Japan","volume":"87","author":"Nishioka","year":"2020","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1038\/s41577-024-01103-8","article-title":"Adipokines: Masterminds of metabolic inflammation","volume":"25","author":"Tilg","year":"2025","journal-title":"Nat. Rev. Immunol."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Starlinger, J., Santol, J., Kaiser, G., and Sarahrudi, K. (2024). Close negative correlation of local and circulating Dickkopf-1 and Sclerostin levels during human fracture healing. Sci. Rep., 14.","DOI":"10.1038\/s41598-024-55756-5"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.jocd.2018.05.039","article-title":"A Prospective Assessment of Periprosthetic Bone Mineral Density and Osteoimmunological Biomarkers Variations after Total Knee Replacement Surgery","volume":"22","author":"Cucchi","year":"2019","journal-title":"J. Clin. Densitom."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1007\/s00404-017-4288-x","article-title":"The relationship between postmenopausal women\u2019s sclerostin levels and their bone density, age, body mass index, hormonal status, and smoking and consumption of coffee and dairy products","volume":"295","author":"Kalem","year":"2017","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.2337\/dc14-2989","article-title":"Sclerostin and Insulin Resistance in Prediabetes: Evidence of a Cross Talk between Bone and Glucose Metabolism","volume":"38","author":"Daniele","year":"2015","journal-title":"Diabetes Care"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Briguglio, M., and Wainwright, T.W. (2025). Towards Personalised Nutrition in Major Orthopaedic Surgery: Elements of Care Process. Nutrients, 17.","DOI":"10.3390\/nu17040700"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/14\/2319\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:09:54Z","timestamp":1760033394000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/14\/2319"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,14]]},"references-count":31,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2025,7]]}},"alternative-id":["nu17142319"],"URL":"https:\/\/doi.org\/10.3390\/nu17142319","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,14]]}}}