Impact of sarcopenia on rehabilitation outcomes after total knee replacement in older adults with knee osteoarthritis

Liao, Chun De; Chen, Hung-Chou; Huang, Shih Wei; Liou, Tsan Hon

doi:10.1177/1759720x21998508

Cited by 9 publications

(12 citation statements)

References 54 publications

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“…Recovery in knee ROM following TKR is likely to be negatively impacted by either obesity [93,96] or sarcopenia [98]. In agreement with prior findings, survival analysis results in the current study demonstrated that the obesity group took a time period of 7 weeks longer than the non-obese control did to recover a knee flexion over 125 degrees.…”

Section: Sarcopenic Obesity and Its Risk Of Poor Recovery In Range Of Motion After Total Knee Replacementsupporting

confidence: 91%

Effects of Sarcopenic Obesity and Its Confounders on Knee Range of Motion Outcome after Total Knee Replacement in Older Adults with Knee Osteoarthritis: A Retrospective Study

Liao

Huang

et al. 2021

Nutrients

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Sarcopenic obesity is closely associated with knee osteoarthritis (KOA) and has high risk of total knee replacement (TKR). In addition, poor nutrition status may lead to sarcopenia and physical frailty in KOA and is negatively associated with surgery outcome after TKR. This study investigated the effects of sarcopenic obesity and its confounding factors on recovery in range of motion (ROM) after total knee replacement (TKR) in older adults with KOA. A total of 587 older adults, aged ≥60 years, who had a diagnosis of KOA and underwent TKR, were enrolled in this retrospective cohort study. Sarcopenia and obesity were defined based on cutoff values of appendicular mass index and body mass index for Asian people. Based on the sarcopenia and obesity definitions, patients were classified into three body-composition groups before TKR: sarcopenic-obese, obese, and non-obese. All patients were asked to attend postoperative outpatient follow-up admissions. Knee flexion ROM was measured before and after surgery. A ROM cutoff of 125 degrees was used to identify poor recovery post-surgery. Kaplan-Meier curve analysis was performed to measure the probability of poor ROM recovery among study groups. Cox multivariate regression models were established to calculate the hazard ratios (HRs) of postoperative poor ROM recovery, using potential confounding factors including age, sex, comorbidity, risk of malnutrition, preoperative ROM, and outpatient follow-up duration as covariates. Analyses results showed that patients in the obese and sarcopenic-obese groups had a higher probability of poor ROM recovery compared to the non-obese group (all p < 0.001). Among all body-composition groups, the sarcopenic-obese group yielded the highest risk of postoperative physical difficulty (adjusted HR = 1.63, p = 0.03), independent to the potential confounding factors. Sarcopenic obesity is likely at the high risk of poor ROM outcome following TKR in older individuals with KOA.

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Section: Sarcopenic Obesity and Its Risk Of Poor Recovery In Range Of Motion After Total Knee Replacementsupporting

confidence: 91%

Effects of Sarcopenic Obesity and Its Confounders on Knee Range of Motion Outcome after Total Knee Replacement in Older Adults with Knee Osteoarthritis: A Retrospective Study

Liao

Huang

et al. 2021

Nutrients

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“…Preoperative functional status predicts the function outcome [26], muscle mass in people with Osteoarthritis is associated with greater impairment [27]. Liao et al [19] ] studied the impact of preoperative extremity skeletal muscle reduction of 190 elderly KOA patients in Taiwan on the clinical rehabilitation results after TKA, indicated that skeletal muscle reduction was negatively correlated to the WOMAC-Function, chair experiments, walking pace test. However, there is no research concentrated on muscle mass of surgical legs to rehabilitation.…”

Section: Discussionmentioning

confidence: 99%

“…Muscle muss loss was also observed after TKA by Hopkins et al [18]. Sarcopenia independently had negative impacts on the rehabilitation of physical mobility after TKA [19], early postoperative training of lower limb muscle strength can promote function recovery [6,20].…”

Section: Introductionmentioning

confidence: 99%

Preoperative lower limb skeletal muscle mass impact functional rehabilitation and mobility ability after total knee arthroplasty for osteoarthritis: a prospective, observational study

Yang

Wang

et al. 2022

Preprint

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Background Despite the remarkably successful treatment of total knee arthroplasty (TKA), several patients also dissatisfied with their function, not met preoperative expectations. The purpose of this study was to investigate the relationship between preoperative lower limb skeletal muscle mass (LSM) and early functional rehabilitation outcome after TKA. Methods 102 patients who underwent a primary unilateral TKA were enrolled to our prospectively observational study. Preoperative variables included demographic (socio-demographic data and disease-related information), LSM, lower limb muscle strength. The HSS and WOMAC-Function scales was used to evaluate knee functional rehabilitation outcome and mobility ability at the time points of preoperative, 3 months and 6 months after TKA. Univariate and multivariate regression analysis was performed with the evaluations at 6 months after TKA as the main outcome measures. Results Multivariate Logistic regression analysis showed that LSM (β = 4.367, p = 0.000) was positively related to functional rehabilitation measured by HSS at 6 months postoperatively; age (β=-0.104, p = 0.007), postoperative pain (β=-1.311, p = 0.000) were negatively related to HSS. The preoperative lower limb skeletal muscle mass showed a significant negative relationship with the postoperative functional activity ability assessed by WOMAC-Function scale (β=-0.208, P = 0.006). Conclusion Lower limb skeletal muscle mass positively impacted on functional rehabilitation and knee mobility ability after TKA in patients with osteoarthritis. LSM should be considered when considering patient`s expectation to achieve higher demanding tasks.

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“…Effect of sarcopenia on the results of total knee arthroplasty in patients with osteoarthritis Due to the fact that sarcopenia is often common in patients with osteoarthritis, researches are being conducted to study the dynamics of the recovery period after total knee arthroplasty. There are two prospective studies showing that after total hip or knee arthroplasty in patients with sarcopenia the length of hospital stay is increased, the percentage of complications, falls, fractures of the lower extremities, and repeated hospitalization are increased [33][34][35].…”

Section: Searching For Associations Between Sarcopenia Sarcopenic Obesity and Osteoarthritis In Population Studiesmentioning

confidence: 99%

“…There is a study of the effect of sarcopenia on the clinical outcome after surgery in patients with knee OA [35]. The authors revealed that patients with sarcopenia had worse WOMAC-PF scores compared to patients without sarcopenia, in addition, the severity of pain in patients with sarcopenia according to the WOMAC scale was more severe.…”

Section: Searching For Associations Between Sarcopenia Sarcopenic Obesity and Osteoarthritis In Population Studiesmentioning

confidence: 99%

Sarcopenia, sarcopenic obesity and osteoarthritis

Dedukh¹,

Zaverukha²,

Bystrytska³

et al. 2021

OTP

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Sarcopenia is considered an important geriatric syndrome, the manifestations of which lead to impaired quality of life and increased mortality. Sarcopenia is a disease associated with decreased muscle mass and strength. Sarcopenic obesity is manifested by an increase in subcutaneous or visceral fat, fatty degeneration of muscles, and is also accompanied by impaired muscle function. After the age of 40, an average of 8 % loss of muscle mass is noted, and by the age of 80 this value can reach 50 %. The review examined the relationship between sarcopenia, sarcopenic obesity, and osteoarthritis (OA).Many exogenous and endogenous factors influence the development and course of OA. Based on the study of mechanisms of cellular and molecular profiles, the specific features for these frequently coexisting pathologies have been identified. The review presents the molecular mechanisms in the development of sarcopenia, sarcopenic obesity and osteoarthritis. Increased fat mass is manifested by increased adipogenesis, expression of inflammatory molecules (leptin, adiponectin, interleukin-1 (IL-1), IL-1b, IL-6 and tumor necrosis factor α) that contribute to chronic low-grade systemic inflammationand negatively affect muscle and joint quality. The relationship between elevated levels of myostatin and muscle weakness as well as myostatin accumulation in synovial fluid and severity of osteoarthritis was considered. Some common mechanisms in the development of sarcopenia and OA were noted: the influence of oxidative stress, systemic chronic inflammation, and disruption of the signaling pathway of bone morphogenetic proteins. Based on the analysis of associations between sarcopenia, sarcopenic obesity, and OA, population-based studies have revealed a high prevalence of knee OA with an increased risk among men with sarcopenic obesity. Women with sarcopenia and sarcopenic obesity had a high risk of knee OA in both groups. The review reviewed the prevention and treatment of the combined pathology, in particular the effect of sarcopenia on the results of total joint а rthroplasty in patients with OA. In general, sarcopenia, sarcopenic obesity, and OA can be considered as concomitant age-associated diseases that jointly affect quality of life and life expectancy.

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Impact of sarcopenia on rehabilitation outcomes after total knee replacement in older adults with knee osteoarthritis

Cited by 9 publications

References 54 publications

Effects of Sarcopenic Obesity and Its Confounders on Knee Range of Motion Outcome after Total Knee Replacement in Older Adults with Knee Osteoarthritis: A Retrospective Study

Effects of Sarcopenic Obesity and Its Confounders on Knee Range of Motion Outcome after Total Knee Replacement in Older Adults with Knee Osteoarthritis: A Retrospective Study

Preoperative lower limb skeletal muscle mass impact functional rehabilitation and mobility ability after total knee arthroplasty for osteoarthritis: a prospective, observational study

Sarcopenia, sarcopenic obesity and osteoarthritis

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