Schwartz AM, Wilson JM, Farley KX, et al. - The present study was sought to evaluate the incidence of their coexistence, and the magnitude of risk they confer to total knee arthroplasty (TKA) patients. Researchers assessed the ACS-NSQIP database to distinguish four patient cohorts: healthy/normal serum albumin, healthy/hypoalbuminemic patients, normoalbuminemic/medically frail patients (defined by modified frailty index), and hypoalbuminemic/frail patients. Both uni- and multivariate analyses were conducted to evaluate the risk conferred by each condition in isolation, and in coexistence. This study included a total of 179,702 elective TKA cases from 2006-18. It was demonstrated that after TKA, frailty and hypoalbuminemia represent distinct conditions and are independent risk factors for a complication. Their coexistence imparts a synergistic correlation with the risk of post-TKA complications.