Johnson NR, Statz JM, Odum SM, et al. - This study was undertaken to explore the consequence of failure to optimize key risk factors in a modern cohort of total knee arthroplasty (TKA) patients. Researchers carried out to search the American College of Surgeons National Surgical Quality Improvement Program database to distinguish patients who underwent TKA in 2017-2018. The study enrolled a total of 84,315 patients. Surgeons continue to operate on patients who are not optimized, despite the knowledge that modifiable risk factors significantly influence postoperative outcomes. The findings suggested that hypoalbuminemia seems to be the strongest risk factor for all complications among the modifiable risk factors. The data considered that special attention should be paid to preoperative nutritional optimization.