End-stage knee osteoarthritis with and without sarcopenia and the effect of knee arthroplasty – a prospective cohort study
Abstract Background Sarcopenia often accompanies osteoarthritis (OA), which is managed by total knee arthroplasty (TKA) in the late stage. Recent studies have suggested a higher risk of post-operative complications after TKA in sarcopenic OA subjects, but whether TKA can benefit them similar to non-...
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doaj-41bc9c563ab642c5beda0a3dd45c1afa2021-01-10T12:15:47ZengBMCBMC Geriatrics1471-23182021-01-0121111110.1186/s12877-020-01929-6End-stage knee osteoarthritis with and without sarcopenia and the effect of knee arthroplasty – a prospective cohort studyKevin Ki-Wai Ho0Lawrence Chun-Man Lau1Wai-Wang Chau2Queena Poon3Kwong-Yin Chung4Ronald Man-Yeung Wong5Department of Orthopaedics and Traumatology, Chinese University of Hong KongDepartment of Orthopaedics and Traumatology, Chinese University of Hong KongDepartment of Orthopaedics and Traumatology, Chinese University of Hong KongDepartment of Orthopaedics and Traumatology, Chinese University of Hong KongDepartment of Orthopaedics and Traumatology, Prince of Wales HospitalDepartment of Orthopaedics and Traumatology, Chinese University of Hong KongAbstract Background Sarcopenia often accompanies osteoarthritis (OA), which is managed by total knee arthroplasty (TKA) in the late stage. Recent studies have suggested a higher risk of post-operative complications after TKA in sarcopenic OA subjects, but whether TKA can benefit them similar to non-sarcopenic subjects remains unexplored. This study aimed to examine the dynamic, mutual impact of sarcopenia and TKA in a one-year post-operative period. Methods This prospective cohort study was conducted between 2015 to 2018 at our hospital. Patients with end-stage OA of the knee waiting for TKA were recruited into the study. Primary outcome measures were change in muscle strength, mass and function. Secondary outcome measures were quality of life (QOL) measurements for pain, psychological and physical health. Results Fifty-eight patients were recruited, of which 79.3% were female and 32.8% already had sarcopenia at baseline. The average age of sarcopenic subjects and non-sarcopenic subjects was comparable (67.89 ± 7.07 vs. 67.92 ± 6.85; p = 0.99), but sarcopenic subjects had a lower body mass index (BMI) (25.64 ± 2.64 vs. 28.57 ± 4.04; p = 0.01). There was a statistically significant improvement in walking speed (10.24 ± 5.35 vs. 7.69 ± 2.68, p < 0.01) and muscle strength in both sarcopenic and non-sarcopenic patients after TKA. This was accompanied by an improvement trend in muscle mass in all subjects. There was no change in handgrip power before and after TKA and subsequent follow-up (19.31 ± 5.92 vs. 18.98 ± 6.37 vs. 19.36 ± 7.66; p = 0.97). QOL measured before, after and at follow-up with WOMAC (total: 42.27 ± 15.98 vs. 20.65 ± 15.24 vs. 16.65 ± 18.13) and SF12v2 (PCS: 33.06 ± 8.55 vs. 38.96 ± 8.01 vs. 40.67 ± 7.93) revealed progressive significant improvement (both comparisons p ≤ 0.01). Further analysis with the IPAQ also found increased engagement of high-intensity activities. Conclusions This study showed that sarcopenia among patients with end-stage OA of the knee is not uncommon, but both sarcopenic and non-sarcopenic OA patients achieved significant clinical and functional improvement after TKA. Further studies with a larger sample size and different ethnicities could help ascertain a beneficial role of TKA in sarcopenic OA subjects. Trial registration Registry: ClinicalTrials.gov , Registration number: NCT03579329 . Date of registration: 6 July 2018. Retrospectively registered.https://doi.org/10.1186/s12877-020-01929-6Knee arthroplastySarcopeniaKnee osteoarthritisSarcopenic obesityCohort study |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kevin Ki-Wai Ho Lawrence Chun-Man Lau Wai-Wang Chau Queena Poon Kwong-Yin Chung Ronald Man-Yeung Wong |
spellingShingle |
Kevin Ki-Wai Ho Lawrence Chun-Man Lau Wai-Wang Chau Queena Poon Kwong-Yin Chung Ronald Man-Yeung Wong End-stage knee osteoarthritis with and without sarcopenia and the effect of knee arthroplasty – a prospective cohort study BMC Geriatrics Knee arthroplasty Sarcopenia Knee osteoarthritis Sarcopenic obesity Cohort study |
author_facet |
Kevin Ki-Wai Ho Lawrence Chun-Man Lau Wai-Wang Chau Queena Poon Kwong-Yin Chung Ronald Man-Yeung Wong |
author_sort |
Kevin Ki-Wai Ho |
title |
End-stage knee osteoarthritis with and without sarcopenia and the effect of knee arthroplasty – a prospective cohort study |
title_short |
End-stage knee osteoarthritis with and without sarcopenia and the effect of knee arthroplasty – a prospective cohort study |
title_full |
End-stage knee osteoarthritis with and without sarcopenia and the effect of knee arthroplasty – a prospective cohort study |
title_fullStr |
End-stage knee osteoarthritis with and without sarcopenia and the effect of knee arthroplasty – a prospective cohort study |
title_full_unstemmed |
End-stage knee osteoarthritis with and without sarcopenia and the effect of knee arthroplasty – a prospective cohort study |
title_sort |
end-stage knee osteoarthritis with and without sarcopenia and the effect of knee arthroplasty – a prospective cohort study |
publisher |
BMC |
series |
BMC Geriatrics |
issn |
1471-2318 |
publishDate |
2021-01-01 |
description |
Abstract Background Sarcopenia often accompanies osteoarthritis (OA), which is managed by total knee arthroplasty (TKA) in the late stage. Recent studies have suggested a higher risk of post-operative complications after TKA in sarcopenic OA subjects, but whether TKA can benefit them similar to non-sarcopenic subjects remains unexplored. This study aimed to examine the dynamic, mutual impact of sarcopenia and TKA in a one-year post-operative period. Methods This prospective cohort study was conducted between 2015 to 2018 at our hospital. Patients with end-stage OA of the knee waiting for TKA were recruited into the study. Primary outcome measures were change in muscle strength, mass and function. Secondary outcome measures were quality of life (QOL) measurements for pain, psychological and physical health. Results Fifty-eight patients were recruited, of which 79.3% were female and 32.8% already had sarcopenia at baseline. The average age of sarcopenic subjects and non-sarcopenic subjects was comparable (67.89 ± 7.07 vs. 67.92 ± 6.85; p = 0.99), but sarcopenic subjects had a lower body mass index (BMI) (25.64 ± 2.64 vs. 28.57 ± 4.04; p = 0.01). There was a statistically significant improvement in walking speed (10.24 ± 5.35 vs. 7.69 ± 2.68, p < 0.01) and muscle strength in both sarcopenic and non-sarcopenic patients after TKA. This was accompanied by an improvement trend in muscle mass in all subjects. There was no change in handgrip power before and after TKA and subsequent follow-up (19.31 ± 5.92 vs. 18.98 ± 6.37 vs. 19.36 ± 7.66; p = 0.97). QOL measured before, after and at follow-up with WOMAC (total: 42.27 ± 15.98 vs. 20.65 ± 15.24 vs. 16.65 ± 18.13) and SF12v2 (PCS: 33.06 ± 8.55 vs. 38.96 ± 8.01 vs. 40.67 ± 7.93) revealed progressive significant improvement (both comparisons p ≤ 0.01). Further analysis with the IPAQ also found increased engagement of high-intensity activities. Conclusions This study showed that sarcopenia among patients with end-stage OA of the knee is not uncommon, but both sarcopenic and non-sarcopenic OA patients achieved significant clinical and functional improvement after TKA. Further studies with a larger sample size and different ethnicities could help ascertain a beneficial role of TKA in sarcopenic OA subjects. Trial registration Registry: ClinicalTrials.gov , Registration number: NCT03579329 . Date of registration: 6 July 2018. Retrospectively registered. |
topic |
Knee arthroplasty Sarcopenia Knee osteoarthritis Sarcopenic obesity Cohort study |
url |
https://doi.org/10.1186/s12877-020-01929-6 |
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