Clinical and Functional Outcomes of Total Knee Arthroplasty in Sarcopenia: A Case–Control Retrospective Cohort Study

He, Zili; Cai, Jie; Wang, Xingyu; Lu, Di

doi:10.1055/s-0041-1740928

Cited by 3 publications

(11 citation statements)

References 22 publications

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“…29 In addition, He et al demonstrated that the sarcopenia group had a higher blood transfusion rate than the non-sarcopenia group in patients undergoing TKA. 12 The discrepancies between our findings and previous studies could be attributed to the use of the ERAS protocol.…”

Section: Total Estimated Blood Loss and Blood Transfusioncontrasting

confidence: 98%

“…11 He et al reported that patients with sarcopenia who underwent TKA had increased postoperative complication rates, such as nausea, vomiting, edema of the operated limb and deep vein thrombosis, compared to the healthy control group. 12 These results were generally in line with our findings. Compared with those in the non-sarcopenia group, patients with sarcopenia had higher surgical complication rates after TKA in this study.…”

Section: Postoperative Complicationssupporting

confidence: 92%

“…10 Another study also demonstrated that there was no significant difference in the LOS between sarcopenia patients and non-sarcopenia patients. 12 However, Bokshan et al found sarcopenia was associated with a longer LOS and an increased risk of in-hospital complications in patients who underwent thoracolumbar spine surgery. 26 In addition, a retrospective matched control study showed patients with sarcopenia had an approximately 5% longer hospital stay compared to controls.…”

Section: Los and Total Hospitalization Costsmentioning

confidence: 99%

“…Several studies have indicated that sarcopenia serves as a predictor of complications and poor prognosis following various surgical procedures, such as gastrointestinal surgery, head and neck surgery, and liver transplantation 7–9 . In the context of total knee arthroplasty (TKA), previous studies have reported that sarcopenia is associated with increased risk of prolonged length of stay, falls, reoperation, and prosthetic joint infection 10–12 . Nevertheless, the impact of sarcopenia on total joint arthroplasty outcomes remains ambiguous, largely attributable to limited follow‐up durations and the scarcity of studies assessing the impact of sarcopenia under the enhanced recovery after surgery (ERAS) protocols.…”

Section: Introductionmentioning

confidence: 99%

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The Negative Impacts of Sarcopenia on Primary Total Knee Arthroplasty under the Enhanced Recovery after Surgery Protocol

Zhou,

Li,

et al. 2024

Orthopaedic Surgery

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ObjectiveSarcopenia, as an emerging public health concern, has been associated with postoperative adverse outcomes in various surgical procedures. However, the evidence regarding the impacts of sarcopenia on total knee arthroplasty (TKA) remained limited. This study aimed to assess the impacts of sarcopenia on primary TKA based on the enhanced recovery after surgery (ERAS) protocol.MethodsThis retrospective study included 291 patients who received unilateral TKA from October 2017 to May 2018 in our institution. Sarcopenia was diagnosed based on the algorithm of Asian Working Group for Sarcopenia 2019. The handgrip strength was measured using a handheld dynamometer and the muscle mass was estimated by a previously validated anthropometric equation. Patients were classified into sarcopenia group and non‐sarcopenia group. The outcomes included complications, postoperative length of stay (LOS), total hospitalization cost, operative time, total estimated blood loss, blood transfusion rate, and the 12‐item forgotten joint score (FJS‐12) at the follow‐up. The propensity score matching (PSM) was used to adjust confounding factors. We compared continuous variables using Student's t‐test and the Wilcoxon Mann–Whitney U test for normal and non‐normal distributions, respectively, and categorical variables with chi‐square tests.ResultsOf the 291 patients, 58 (19.9%) patients were identified as having sarcopenia. After PSM, each group matched 42 patients. All matched patients were followed‐up at least 5 years. Patients with sarcopenia had higher rates of surgical complications compared to the non‐sarcopenia group (p = 0.019), and no significant difference was observed in 30‐day readmission, and periprosthetic joint infection. The sarcopenia group had significantly longer LOS (p = 0.038), higher total hospitalization (p = 0.015) than the non‐sarcopenia group. For the FJS‐12 scores at follow‐up, patients with sarcopenia had significantly higher scores than the non‐sarcopenia group (p = 0.024).ConclusionOur findings indicated sarcopenia may be a risk factor for postoperative complications, prolonged LOS, increased hospitalization cost and reduced patient satisfaction.

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Section: Total Estimated Blood Loss and Blood Transfusioncontrasting

confidence: 98%

Section: Postoperative Complicationssupporting

confidence: 92%

Section: Los and Total Hospitalization Costsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Negative Impacts of Sarcopenia on Primary Total Knee Arthroplasty under the Enhanced Recovery after Surgery Protocol

Zhou,

Li,

et al. 2024

Orthopaedic Surgery

View full text Add to dashboard Cite

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“…The non-parametric Mann–Whitney test was used for the comparison between the two groups for the variables “Disease Index” and “Waist/heel ratio”. Two-way repeated measures analysis of variance (ANOVA) was performed to compare the mean values of the dependent variable KOOS between the two groups (non-sarcopenic and sarcopenic) before and after surgery (main effects and interaction), as previously described [ 40 ]. Results are presented as mean ± standard deviation, and the level of statistical significance was set at the p < 0.05 level.…”

Section: Methodsmentioning

confidence: 99%

Comparative Analysis on the Effect of Sarcopenia in Patients with Knee Osteoarthritis before and after Total Knee Arthroplasty

et al. 2023

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Introduction: Primary sarcopenia is an age-related disease that occurs mainly in older adults, while its possibility of appearance increases with age. Secondary sarcopenia is related to the presence of a disease. At times, studies have implied a connection between various diseases and the appearance of sarcopenia. Due to pain, patients with knee osteoarthritis limit their everyday activities, leading to a decrease in muscle mass and physical function. Purpose: This study aimed to investigate the impact of the coexistence of sarcopenia and osteoarthritis on patients’ rehabilitation and symptoms, such as pain, after total knee arthroplasty , compared with patients with osteoarthritis without sarcopenia. Methodology: This cross-sectional study material consisted of 20 patients with osteoarthritis, who were hospitalized at Papageorgiou Hospital of Thessaloniki for total knee arthroplasty from November 2021 to April 2022. The patients were evaluated for sarcopenia according to the FNIH criteria. The two groups were asked to complete the KOOS score questionnaire in order to evaluate the condition of their knee in two phases, before surgery and 3 months after surgery. Results: The two groups, 5 sarcopenic patients and 15 non-sarcopenic, did not show a statistically significant difference in muscle strength measurements. However, the lean mass indices, ALM (15.18 ± 3.98 versus 19.96 ± 3.65, respectively; p = 0.023) and ALM/height2 (5.53 ± 1.40 versus 6.98 ± 0.75, respectively; p = 0.007) had significant differences, since the sarcopenic group showed a reduced lean mass, especially in patients with a comorbidity of cancer. Sarcopenic patients showed a smaller increase in KOOS score compared to non-sarcopenic patients before (0.38 ± 0.09 vs. 0.35 ± 0.09, respectively; p = 0.312) and after surgery (0.54 ± 0.08 vs. 0.59 ± 0.10, respectively; p = 0.909), but without a statistically significant difference. The score increased for both groups, with the time factor playing a greater role than the group. Conclusions: Both the sarcopenic group and the control group did not show significant differences in their scores for the assessment of the affected limb in any of the two phases while completing the questionnaire. However, there was an improvement in their osteoarthritis symptoms before and after arthroplasty in both groups. Further research with a larger sample and longer recovery time is needed to draw more accurate conclusions and confirm the present results.

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Definitions and adverse outcomes of sarcopenia in older patients in orthopedic and trauma care: A scoping review on current evidence

Gewiess,

Kreuzer,

Eggimann

et al. 2024

Eur J Trauma Emerg Surg

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Purpose Sarcopenia, defined as the loss of muscle mass and strength, can hinder postoperative recovery and raise mortality rates. However, the current evidence on the harmful effects of sarcopenia in older patients in orthopedic and trauma care is unclear. This scoping review investigates different definitions that were used for the diagnosis of sarcopenia in older patients in orthopedic and trauma care and what adverse consequences have been examined. Methods We performed a comprehensive literature search in PubMed and Embase, following the PRISMA guidelines. We included original studies that examined clinical outcomes (such as length of hospital stay, rate of non-home discharge, rate of subsequent falls, rate of refractures, mortality, and functional outcome/quality of life) in older patients in orthopedic and trauma care (aged 65 years and above) with diagnosed sarcopenia (S) compared to a group without sarcopenia (NS). Results Our search identified 2,748 publications. Out of these, 23 articles met the inclusion criteria. Most publications were from Asia (n = 13). A total of 6174 patients were examined, with a prevalence of sarcopenia in 14–92%. 11 articles focused on patients with hip joint pathologies. Most studies diagnosed sarcopenia according to the Asian Working Group on Sarcopenia (AWGSOP1 or AWGSOP2) definitions (n = 10). Length of hospital stay was investigated in 13 studies. Seven studies assessed rates of non-home discharge rates. Subsequent falls were not investigated in any of the studies. 1 study reported the overall refracture rate (S: 10.4%; NS: 5.8%). Mortality was assessed in 11 studies (S: 1–60.5%; NS: 0–39.5%). The functional outcome/quality of life was investigated by 17 studies (Barthel Index decline S: -4.5 to -15.3 points; NS: -11.7 to -54.7 points). Conclusion Sarcopenia has been increasingly studied in older patients in orthopedic and trauma care but there is a lack of consistent definition criteria. This scoping review suggests that sarcopenia may be associated with prolonged length of stay, higher rates of non-home discharge, and increased mortality among older patients in orthopedic and trauma care. However, prospective studies are necessary to establish the relationship between sarcopenia and refractures, falls, and functional outcome/quality of life among older patients in orthopedic and trauma care.

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Clinical and Functional Outcomes of Total Knee Arthroplasty in Sarcopenia: A Case–Control Retrospective Cohort Study

Cited by 3 publications

References 22 publications

The Negative Impacts of Sarcopenia on Primary Total Knee Arthroplasty under the Enhanced Recovery after Surgery Protocol

The Negative Impacts of Sarcopenia on Primary Total Knee Arthroplasty under the Enhanced Recovery after Surgery Protocol

Comparative Analysis on the Effect of Sarcopenia in Patients with Knee Osteoarthritis before and after Total Knee Arthroplasty

Definitions and adverse outcomes of sarcopenia in older patients in orthopedic and trauma care: A scoping review on current evidence

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