Inui Kentaro, Maeda Shingo, Yamada Shuji, Mandai Koji, Minami Yoshito, Ueno Kentaro, Ohashi Hirotsugu, Ikawa Tesshu
Department of Orthopaedic Surgery, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan.
Department of Orthopaedic Surgery, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan.
Mod Rheumatol. 2025 Apr 8;35(3):579-584. doi: 10.1093/mr/roae093.
We assessed physical function by three different methods in patients with knee osteoarthritis just before total knee arthroplasty (TKA) and investigated the relationship with pre-operative factors.
All patients scheduled to undergo TKA were assessed for basic attributes, clinical assessment, radiography, whole-body mode dual-energy X-ray absorptiometry, knee muscle strength, and frailty, sarcopenia, locomotive syndrome (LS) were evaluated.
Among 204 patients (213 knees), 172 women the overall distribution in frailty was no: 14.6%, pre-frailty: 58.5%, frailty: 26.8%; in sarcopenia no: 93.3%, yes: 3.4%, severe: 3.4%; and in LS Stage 0: 0%, Stage 1: 3.3%, Stage 2: 11.4%, Stage 3: 85.3% . Eighty-seven per cent of the patients with frailty and 92% with LS Stage 3 did not suffer from sarcopenia. Statistically significant relationships were observed between sarcopenia and frailty, while there was no relationship between LS and frailty or LS and sarcopenia. Multivariate analysis of related factors with severity levels for frailty and LS revealed statistically significant correlations for frailty with gait speed, and LS with Knee Society Score and muscle strength.
In patients with knee osteoarthritis frailty and LS were not related to sarcopenia. Knee joint dysfunction without sarcopenia was well reflected by LS, but not by frailty.
我们在全膝关节置换术（TKA）即将进行之前，通过三种不同方法评估了膝关节骨关节炎患者的身体功能，并研究了其与术前因素的关系。
对所有计划接受TKA的患者进行基本属性、临床评估、影像学检查、全身模式双能X线吸收法、膝关节肌肉力量评估，并对衰弱、肌肉减少症、运动机能综合征（LS）进行评估。
在204例患者（213个膝关节）中，女性172例。衰弱的总体分布为：无衰弱：14.6%，前期衰弱：58.5%，衰弱：26.8%；肌肉减少症的分布为：无：93.3%，有：3.4%，严重：3.4%；LS的分布为：0期：0%，1期：3.3%，2期：11.4%，3期：85.3%。87%的衰弱患者和92%的LS 3期患者未患肌肉减少症。观察到肌肉减少症与衰弱之间存在统计学显著关系，而LS与衰弱之间或LS与肌肉减少症之间无关系。对衰弱和LS严重程度相关因素的多变量分析显示，衰弱与步态速度、LS与膝关节协会评分及肌肉力量之间存在统计学显著相关性。
在膝关节骨关节炎患者中，衰弱和LS与肌肉减少症无关。无肌肉减少症的膝关节功能障碍在LS中得到很好反映，但在衰弱中未得到反映。
