Heo Juneyoung, Koh Han-Seung, Nam Chang Hyun, Lee Dong-Chan, Baek Ji-Hoon, Ahn Hye Sun, Lee Su Chan
Joint & Arthritis Research, Department of Neurosurgery, Himchan Hospital, Seoul 07999, Republic of Korea.
Joint & Arthritis Research, Department of Orthopaedic Surgery, Himchan Hospital, Seoul 07999, Republic of Korea.
J Clin Med. 2024 Nov 7;13(22):6700. doi: 10.3390/jcm13226700.
To investigate the effects of total knee arthroplasty (TKA) on muscle mass and bone density in end-stage knee osteoarthritis (OA). This prospective study was conducted on 111 patients with Kellgren-Lawrence grade 4 knee OA who underwent TKA after failing to respond to conservative treatment for more than 3 months at a single institution from June 2022 to May 2023. Appendicular lean mass index (ALMI) and bone mineral density (BMD) were measured using dual-energy X-ray absorptiometry before and every 6 months after surgery. The average follow-up period was 15.5 ± 2.31 months (range, 11.6-24 months). During the follow-up period after TKA, the ALMI increased relatively continuously and consistently. The BMD of the L-spine and proximal femur did not change significantly until 12 months after TKA surgery but began to increase steeply after 12 months and slowed down after 18 months. The increase in muscle mass showed a significant positive correlation with the increase in BMD. Muscle mass gradually increased after TKA for end-stage knee OA, whereas bone density also increased but not until 12 months after surgery. The significant positive correlation between the increase in muscle mass and bone density suggests that the increase in muscle mass after TKA may be one of the causes of the increase in bone density.
探讨全膝关节置换术（TKA）对终末期膝骨关节炎（OA）肌肉质量和骨密度的影响。本前瞻性研究于2022年6月至2023年5月在一家机构对111例Kellgren-Lawrence 4级膝OA患者进行，这些患者在接受保守治疗3个月以上无效后接受了TKA。采用双能X线吸收法在手术前及术后每6个月测量四肢瘦体重指数（ALMI）和骨密度（BMD）。平均随访期为15.5±2.31个月（范围11.6 - 24个月）。在TKA后的随访期间，ALMI相对持续且稳定地增加。腰椎和股骨近端的BMD在TKA手术后12个月内无明显变化，但在12个月后开始急剧增加，18个月后增速放缓。肌肉质量的增加与BMD的增加呈显著正相关。终末期膝OA患者TKA后肌肉质量逐渐增加，而骨密度也增加，但在术后12个月才开始。肌肉质量增加与骨密度之间的显著正相关表明，TKA后肌肉质量的增加可能是骨密度增加的原因之一。
