Department of Rehabilitation, Nagoya University Hospital, Nagoya 466-8560, Japan.
Department of Rehabilitation, Toyota Memorial Hospital, Toyota 471-8513, Japan.
Nutrients. 2024 Jun 29;16(13):2085. doi: 10.3390/nu16132085.
The outcome of total hip arthroplasty (THA) in patients with end-stage arthritis of the hip is associated with preoperative physical status. This study was performed to examine the relationship between the preoperative severity of sarcopenia and clinical outcomes after THA. This retrospective cohort study was performed among 306 consecutive patients (mean age: 63.7 ± 12.9 years, 222 women) undergoing THA at a university hospital. The severity of sarcopenia was determined based on the skeletal muscle mass index (SMI), handgrip strength, and gait speed according to the criteria of the Asian Working Group for Sarcopenia 2019. The severe sarcopenia prevalence rate was 10.6%. Severe sarcopenia was significantly associated with the risk of delayed functional recovery (adjusted odds ratio, 2.82; 95% confidence interval, 1.03-7.72; = 0.043) compared with the non-sarcopenia group after adjusting for pre-existing risk factors, including preoperative hip function and physical activity. The addition of SMI, handgrip strength, and gait speed to the model for risk of functional recovery delay significantly increased the area under the receiver operating characteristic curve ( = 0.038). Severe sarcopenia was significantly associated with poorer hip function and patient-reported outcomes at 6 months after surgery compared with the non-sarcopenia group. Severe sarcopenia was adversely associated with postoperative clinical outcomes in patients undergoing THA.
全髋关节置换术(THA)治疗髋关节终末期关节炎的疗效与术前身体状况相关。本研究旨在探讨术前肌少症严重程度与 THA 后临床疗效的关系。该回顾性队列研究纳入了在一所大学医院接受 THA 的 306 例连续患者(平均年龄:63.7 ± 12.9 岁,222 例女性)。根据亚洲肌少症工作组 2019 年的标准,通过骨骼肌质量指数(SMI)、握力和步态速度来确定肌少症的严重程度。严重肌少症的患病率为 10.6%。与非肌少症组相比,严重肌少症患者术后功能恢复延迟的风险显著增加(校正比值比,2.82;95%置信区间,1.03-7.72;P = 0.043),校正了包括术前髋关节功能和体力活动在内的已有风险因素。将 SMI、握力和步态速度添加到功能恢复延迟风险模型中,显著提高了曲线下面积(P = 0.038)。与非肌少症组相比,术后 6 个月时严重肌少症患者的髋关节功能和患者报告的结局明显较差。严重肌少症与接受 THA 的患者的术后临床结局不良相关。