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In TKA patients, the level of frailty, as measured by the HFRS, was a predictor of elevated adverse events and increased health care burdens. HFRS offers a means of rapidly identifying high-risk patients scheduled for total knee arthroplasty (TKA), with the potential for pre-operative optimization. Retrospective cohort study, a Level III analysis. A retrospective cohort study at Level III. Visceral obesity, a reliable indicator of