Shin Won Chul, Jang Jae Hoon, Seo Han Eol, Suh Kuen Tak, Moon Nam Hoon
Department of Orthopaedic Surgery, Pusan National University, Yangsan Hospital, Busan, Korea.
Department of Orthopaedic Surgery, Bio-medical Research Institute, Pusan National University Hospital, Busan, Korea.
Acta Orthop Traumatol Turc. 2020 Jan;54(1):27-33. doi: 10.5152/j.aott.2020.01.476.
The study aimed to identify the prevalence of sarcopenia in patients with osteoporotic hip fractures, investigate the anthropometric differences between sarcopenic and non-sarcopenic patients, and evaluate and compare the surgical outcomes between the two groups.
The study included 135 patients (35 men and 100 women; mean age: 74.1 years (range; 25-96)) who received surgical treatment for hip fracture between March 2014 and October 2016 and underwent whole-body dual-energy X-ray absorptiometry (DEXA). The skeletal muscle mass index (SMI) for diagnosis of sarcopenia was measured using whole-body DEXA. The following data were collected to compare the preoperative details of the sarcopenic and non-sarcopenic groups: SMI, age, sex, type of fracture, type of operation, BMI, obesity, American society of Anesthesiologists (ASA) class, pre-injury mobility score, BMD, and follow-up period. We compared clinical outcomes, including Harris Hip Score (HSS) and the walking ability at the last follow-up visit and radiologic outcomes, including non-union and the time to union.
The average HHS and Parker's mobility score at the last follow-up were 81.7 and 6.9 in the sarcopenic group, and 77.6 and 6.3 in the non-sarcopenic group, respectively (p=0.149 and 0.122). Non-union was identified 0 (0%) in sarcopenic group and 4 (10%) in non-sarcopenic group (p=0.288). The mean union timer of the patients in the sarcopenia group was 4.0 months and that of patients in the non-sarcopenic group was 4.4 months (p=0.210). Multiple regression analysis did not show any significant association between sarcopenia and postoperative surgical outcomes, including HHS, mobility score at the last follow up, non-union, and time to union.
Although the present study showed that the prevalence of sarcopenia in hip fracture patients was 45.9% (62/135), there was no clinical association between sarcopenia and postoperative. Based on these results, the clinical impact of sarcopenia may be confined to increased risk of hip fracture occurrence and surgical outcomes of hip fracture may not be affected by sarcopenia.
Level III, Therapeutic Study.
本研究旨在确定骨质疏松性髋部骨折患者中肌肉减少症的患病率，调查肌肉减少症患者与非肌肉减少症患者的人体测量学差异，并评估和比较两组患者的手术结果。
本研究纳入了135例患者（35例男性和100例女性；平均年龄：74.1岁（范围：25 - 96岁）），这些患者在2014年3月至2016年10月期间接受了髋部骨折手术治疗，并进行了全身双能X线吸收法（DEXA）检查。使用全身DEXA测量用于诊断肌肉减少症的骨骼肌质量指数（SMI）。收集以下数据以比较肌肉减少症组和非肌肉减少症组的术前详细情况：SMI、年龄、性别、骨折类型、手术类型、BMI、肥胖情况、美国麻醉医师协会（ASA）分级、伤前活动评分、骨密度和随访期。我们比较了临床结果，包括Harris髋关节评分（HSS）和最后一次随访时的行走能力，以及放射学结果，包括骨不连和愈合时间。
肌肉减少症组最后一次随访时的平均HHS和帕克活动评分分别为81.7和6.9，非肌肉减少症组分别为77.6和6.3（p = 0.149和0.122）。肌肉减少症组骨不连发生率为0（0%），非肌肉减少症组为4例（10%）（p = 0.288）。肌肉减少症组患者的平均愈合时间为4.0个月，非肌肉减少症组患者为4.4个月（p = 0.210）。多元回归分析未显示肌肉减少症与术后手术结果之间存在任何显著关联，包括HHS、最后一次随访时的活动评分、骨不连和愈合时间。
尽管本研究显示髋部骨折患者中肌肉减少症的患病率为45.9%（62/135），但肌肉减少症与术后情况之间无临床关联。基于这些结果，肌肉减少症的临床影响可能仅限于髋部骨折发生风险增加，髋部骨折的手术结果可能不受肌肉减少症影响。
三级，治疗性研究。
