Chang Kenny, Albright J Alex, Testa Edward J, Balboni Alanna B, Daniels Alan H, Cohen Eric
Warren Alpert Medical School of Brown University, Providence, RI 02903, USA.
Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA.
Biology (Basel). 2023 Feb 13;12(2):295. doi: 10.3390/biology12020295.
Sarcopenia is a state of catabolic muscle wasting prevalent in geriatric patients. Likewise, osteoarthritis is an age-related musculoskeletal disease affecting patients with similar demographics. Late-stage hip osteoarthritis is often treated with total hip arthroplasty (THA). As sarcopenia influences the surgical outcomes, this study aimed to assess the impact of sarcopenia on the outcomes of THA. A 1:3 matched case-control study of sarcopenic to control patients was performed using a large national database. In total, 3992 patients were analyzed. Sarcopenic patients undergoing THA were more likely to experience dislocation (odds ratio (OR) = 2.19, 95% confidence interval (CI) 1.21-3.91) within 1 year of THA. Furthermore, sarcopenic patients had higher urinary tract infection rates (OR = 1.79, CI 1.32-2.42) and a greater risk of 90-day hospital readmission (hazard ratio (HR) = 1.39, CI 1.10-1.77). Sarcopenic patients experienced more falls (OR = 1.62, CI 1.10-2.39) and fragility fractures (OR = 1.77, CI 1.34-2.31). Similarly, sarcopenic patients had higher day of surgery costs (USD 13,534 vs. USD 10,504) and 90-day costs (USD 17,139 vs. USD 13,394) compared with the controls. Ultimately, sarcopenic patients undergoing THA experience higher rates of postoperative complications and incur greater medical costs. Given the potential risks, orthopedic surgeons may consider treating or reducing the severity of sarcopenia before surgery.
肌肉减少症是一种分解代谢性肌肉消耗状态,在老年患者中普遍存在。同样,骨关节炎是一种与年龄相关的肌肉骨骼疾病,影响着具有相似人口统计学特征的患者。晚期髋骨关节炎通常采用全髋关节置换术(THA)治疗。由于肌肉减少症会影响手术结果,本研究旨在评估肌肉减少症对THA结果的影响。使用一个大型国家数据库对肌肉减少症患者与对照患者进行了1:3匹配的病例对照研究。总共分析了3992名患者。接受THA的肌肉减少症患者在THA后1年内更有可能发生脱位(优势比(OR)=2.19,95%置信区间(CI)1.21 - 3.91)。此外,肌肉减少症患者的尿路感染率更高(OR = 1.79,CI 1.32 - 2.42),90天内再次入院的风险更大(风险比(HR)= 1.39,CI 1.10 - 1.77)。肌肉减少症患者跌倒(OR = 1.62,CI 1.10 - 2.39)和脆性骨折(OR = 1.77,CI 1.34 - 2.31)的情况更多。同样,与对照组相比,肌肉减少症患者的手术日费用更高(13,534美元对10,504美元)和90天费用更高(17,139美元对13,394美元)。最终,接受THA的肌肉减少症患者术后并发症发生率更高,医疗费用更高。鉴于潜在风险,骨科医生在手术前可能会考虑治疗或减轻肌肉减少症的严重程度。