Tzartza Chrysanthi Liliana, Karapalis Nikolaos, Voulgaridou Gavriela, Zidrou Christiana, Beletsiotis Anastasios, Chatziprodromidou Ioanna P, Giaginis Constantinos, Papadopoulou Sousana K
Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece.
2nd Orthopaedic Department, G. Papageorgiou General Hospital, 54453 Thessaloniki, Greece.
Diseases. 2023 Feb 22;11(1):36. doi: 10.3390/diseases11010036.
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.
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.
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.
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; = 0.023) and ALM/height (5.53 ± 1.40 versus 6.98 ± 0.75, respectively; = 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; = 0.312) and after surgery (0.54 ± 0.08 vs. 0.59 ± 0.10, respectively; = 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.
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.
原发性肌肉减少症是一种主要发生在老年人中的与年龄相关的疾病，其出现的可能性随年龄增长而增加。继发性肌肉减少症与疾病的存在有关。有时，研究暗示了各种疾病与肌肉减少症出现之间的联系。由于疼痛，膝骨关节炎患者会限制日常活动，导致肌肉量和身体功能下降。
本研究旨在调查与无肌肉减少症的骨关节炎患者相比，肌肉减少症和骨关节炎共存对全膝关节置换术后患者康复及疼痛等症状的影响。
本横断面研究材料包括20例骨关节炎患者，他们于2021年11月至2022年4月在塞萨洛尼基的帕帕佐格鲁医院住院接受全膝关节置换术。根据美国国立卫生研究院（FNIH）标准对患者进行肌肉减少症评估。两组患者均被要求完成膝关节损伤和骨关节炎疗效评分（KOOS）问卷，以便在手术前和手术后3个月分两个阶段评估其膝关节状况。
两组，即5例肌肉减少症患者和15例非肌肉减少症患者，在肌肉力量测量方面未显示出统计学上的显著差异。然而，瘦体重指数，即去脂体重（ALM）（分别为15.18±3.98与19.96±3.65；P = 0.023）和ALM/身高（分别为5.53±1.40与6.98±0.75；P = 0.007）存在显著差异，因为肌肉减少症组的瘦体重减少，尤其是合并癌症的患者。与非肌肉减少症患者相比，肌肉减少症患者在手术前（分别为0.38±0.09与0.35±0.09；P = 0.312）和手术后（分别为0.54±0.08与0.59±0.10；P = 0.909）的KOOS评分增加较小，但无统计学显著差异。两组评分均增加，时间因素比组别起的作用更大。
在完成问卷的两个阶段中，肌肉减少症组和对照组在评估患侧肢体的评分方面均未显示出显著差异。然而，两组在关节置换术前和术后的骨关节炎症状均有改善。需要进行更大样本量和更长恢复时间的进一步研究，以得出更准确的结论并证实目前的结果。
