Conceptualizing Biological Aging and Frailty in Orthopaedics

➤ Biological aging can best be conceptualized clinically as a combination of 3 components: frailty, comorbidity, and disability.➤ Despite advancements in the understanding of senescence, chronological age remains the best estimate of biological age. However, a useful exercise for practitioners is to look beyond chronological age in clinical and surgical decision-making.➤ A chronologically aging person does not age biologically at the same rate.➤ The best way to understand frailty is to consider it as a physical phenotype.➤ Physical optimization should parallel medical optimization before elective surgery.➤ The poorer the host (both in terms of bone quality and propensity for healing), the more robust the implant construct must be to minimize reliance on host biology.