Li Lingzhi, Zhong Jun, Wang Zhaojun, Li Zheng, Liu Xu, Wang Min, Zhang Jingjing, Li Min, Li Zhong
Department of Orthopedics, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan Province, People's Republic of China.
Sichuan Provincial Laboratory of Orthopaedic Engineering, Luzhou, 646000, Sichuan Province, People's Republic of China.
Sci Rep. 2025 May 25;15(1):18272. doi: 10.1038/s41598-025-02754-w.
Sarcopenia diagnosed via opportunistic computed tomography (CT) is linked to poor postoperative outcomes. This study aimed to investigate the association between chest CT-diagnosed sarcopenia and post-total knee arthroplasty (TKA) functional outcomes. This single-center retrospective cohort study included 158 knee osteoarthritis (KOA) patients who underwent primary TKA between January 2021 and June 2022. Sarcopenia was defined using skeletal muscle index values derived from chest CT images at the T12 vertebral level. Sociodemographic, clinical, and perioperative data were collected, and functional outcomes were assessed via the Hospital for Special Surgery (HSS) score at 6 months postoperatively. Univariate and multivariate analyses identified independent risk factors for poorer postoperative functional outcomes in KOA patients undergoing TKA. The prevalence of sarcopenia in the cohort was 48.7%. At 6 months after TKA, sarcopenic patients had significantly lower HSS scores (P < 0.05). Advanced age (P = 0.025), higher body mass index (P = 0.027), sarcopenia (P = 0.020), and higher postoperative pain scores (P < 0.001) were independently associated with poorer functional outcomes. The results indicate that chest CT-determined sarcopenia is prevalent among KOA patients undergoing TKA and is significantly associated with poorer functional outcomes.
通过机会性计算机断层扫描（CT）诊断的肌肉减少症与术后不良结局相关。本研究旨在探讨胸部CT诊断的肌肉减少症与全膝关节置换术（TKA）后功能结局之间的关联。这项单中心回顾性队列研究纳入了2021年1月至2022年6月期间接受初次TKA的158例膝骨关节炎（KOA）患者。使用从T12椎体水平的胸部CT图像得出的骨骼肌指数值来定义肌肉减少症。收集了社会人口统计学、临床和围手术期数据，并在术后6个月通过特种外科医院（HSS）评分评估功能结局。单因素和多因素分析确定了接受TKA的KOA患者术后功能结局较差的独立危险因素。该队列中肌肉减少症的患病率为48.7%。TKA术后6个月，肌肉减少症患者的HSS评分显著较低（P < 0.05）。高龄（P = 0.025）、较高的体重指数（P = 0.027）、肌肉减少症（P = 0.020）和较高的术后疼痛评分（P < 0.001）与较差的功能结局独立相关。结果表明，胸部CT确定的肌肉减少症在接受TKA的KOA患者中普遍存在，并且与较差的功能结局显著相关。
