Do You Order Lab Tests for Nutritional Parameters Before TKA? I Don’t.

There are too many misunderstandings on this topic to count.

Editor’s Note: Sometimes at CORRelations, we’ll cover an article we think may cross your desk because we have reservations about the message. Here’s one. — SSL

What’s the Claim?

Authors of a large-database study found that laboratory tests for nutritional markers (like low prealbumin levels) are performed rarely before TKA (0.2% of patients were tested for zinc, about 2% for prealbumin and transferrin, and 10% for vitamin D). The frequency with which these tests are ordered has increased somewhat over time. For example, prealbumin was ordered in 0.8% of patients in 2011 and 3.4% in 2020.

The authors were troubled by this finding, suggesting that it reflects an important disconnect between everyday practice and available evidence linking laboratory markers of malnutrition with surgical complications after arthroplasty. They somewhat haughtily offer a solution — “These results suggest that orthopaedic surgeons may require additional education in following the literature . . .”

I disagree. I think that orthopaedic surgeons are doing just fine on this. Let’s talk about why.

How’s It Stack Up?