Stefanini Niccolò, Di Martino Alberto, Brunello Matteo, Morandi Guaitoli Manuele, Di Censo Chiara, Geraci Giuseppe, Pilla Federico, Faldini Cesare
1st Orthopedic Department, IRCCS - Istituto Ortopedico Rizzoli, Bologna, Italy.
Department of Biomedical and Neurimotor Sciences -DIBINEM- University of Bologna, Bologna, Italy.
Musculoskelet Surg. 2025 Sep 8. doi: 10.1007/s12306-025-00923-8.
Sarcopenia is a pathologic condition frequent in aged population, leading to functional and cognitive impairment. Given the ageing of the population worldwide, the topic has generated interest in the last decades and is expected to be more relevant in the near future. This paper aims to present the mechanism of sarcopenia, the current state of knowledge regarding diagnosis and treatment and the role of sarcopenia in orthopaedic and traumatological settings. Sarcopenia is an age-related condition which overlaps with other features of frailty syndrome by similar biochemical pathways. It is characterized by a loss of muscle mass and function, mainly due to reduced anabolism. The importance of prompt diagnosis is highlighted; however, there is a lack of standardized cut-offs, thus affecting also non-pharmacological and pharmacological therapeutic options, which are not well defined. The increased risk of falls, disability, cognitive impairment and association with osteoporosis exacerbates fracture risk. Post-surgery inactivity contributes to sarcopenia, which also leads to prolonged hospital stays, increased complications and worse clinical outcomes.
Ageing of population will increase chronic-related conditions. Sarcopenia is a growing and still largely unexplored clinical challenge. Research should focus on diagnostic thresholds and therapeutic protocols to promote interdisciplinary assessment and targeted interventions. In the orthopaedic field, attention ranges from the prevention of fragility fractures to proper perioperative management.
肌肉减少症是老年人群中常见的病理状况,会导致功能和认知障碍。鉴于全球人口老龄化,该话题在过去几十年中引发了关注,并且预计在不久的将来会变得更加重要。本文旨在阐述肌肉减少症的机制、关于诊断和治疗的当前知识状况以及肌肉减少症在骨科和创伤学环境中的作用。肌肉减少症是一种与年龄相关的状况,通过相似的生化途径与衰弱综合征的其他特征重叠。它的特征是肌肉质量和功能丧失,主要是由于合成代谢减少。强调了及时诊断的重要性;然而,缺乏标准化的临界值,这也影响了尚未明确界定的非药物和药物治疗选择。跌倒、残疾、认知障碍风险增加以及与骨质疏松症的关联会加剧骨折风险。术后不活动会导致肌肉减少症,这也会导致住院时间延长、并发症增加以及临床结果更差。
人口老龄化将增加慢性相关疾病。肌肉减少症是一个日益严峻且在很大程度上仍未得到充分探索的临床挑战。研究应聚焦于诊断阈值和治疗方案,以促进多学科评估和针对性干预。在骨科领域,关注范围从预防脆性骨折到适当的围手术期管理。