Comparative Analysis on the Effects of Sarcopenia following Primary Total Knee Arthroplasty: A Retrospective Matched-Control Analysis

Abstract

<jats:title>Abstract</jats:title><jats:p>Despite the high incidence of sarcopenia in the orthopaedic community, studies evaluating the influence of sarcopenia following primary total knee arthroplasty (TKA) are limited. Therefore, the purpose of this study is to determine if sarcopenic patients undergoing primary TKA have higher rates of (1) in-hospital lengths of stay (LOS); (2) medical complications; (3) implant-related complications; (4) fall risk; (5) lower extremity fracture risk; and (6) costs of care. Sarcopenia patients were matched to controls in a 1:5 ratio according to age, sex, and medical comorbidities. The query yielded 90,438 patients with (n = 15,073) and without (n = 75,365) sarcopenia undergoing primary TKA. Primary outcomes analyzed included: in-hospital LOS, 90-day medical complications, 2-year implant-related complications, fall risk, lower extremity fracture risk, and costs of care. A p-value of less than 0.05 was considered statistically significant. Patients with sarcopenia undergoing primary TKA had greater in-hospital LOS (4 vs. 3 days, p &lt; 0.0001). Sarcopenic patients were also found to have increased incidence and odds of 90-day medical complications (2.9 vs. 1.1%; odds ratio [OR] = 2.83, p &lt; 0.0001), falls (0.9 vs. 0.3%; OR = 3.54, p &lt; 0.0001), lower extremity fractures (1.0 vs. 0.2%; OR = 5.54, p &lt; 0.0001), and reoperation (0.9 vs. 0.5%; OR = 1.87, p &lt; 0.0001). Additionally, sarcopenic patients had greater 2-year implant-related complications (4.3 vs. 2.4%; OR = 1.80, p &lt; 0.0001), as well as day of surgery ($52,900 vs. 48,248, p &lt; 0.0001), and 90-day ($68,303 vs. $57,671, p &lt; 0.0001) costs compared with controls. This analysis of over 90,000 patients demonstrates that patients with sarcopenia undergoing primary TKA have greater in-hospital LOS, increased odds of 90-day medical complications, falls, lower extremity fractures, and reoperations. Additionally, sarcopenia was associated with greater 2-year implant-related complications, day of surgery costs, and 90-day costs. The study is useful as it can allow orthopaedic surgeons to properly educate these patients of the potential complications which may occur following their surgery.</jats:p>

Sarcopenia, sarcopenic obesity and osteoarthritis

“…Effect of sarcopenia on the results of total knee arthroplasty in patients with osteoarthritis Due to the fact that sarcopenia is often common in patients with osteoarthritis, researches are being conducted to study the dynamics of the recovery period after total knee arthroplasty. There are two prospective studies showing that after total hip or knee arthroplasty in patients with sarcopenia the length of hospital stay is increased, the percentage of complications, falls, fractures of the lower extremities, and repeated hospitalization are increased [33][34][35].…”

End-stage knee osteoarthritis with and without sarcopenia and the effect of knee arthroplasty – a prospective cohort study

“…It has been widely accepted that TKA greatly increases social and physical aspects of quality of life [21][22][23][24]. Despite the common coprevalence of sarcopenia and OA, reports on the impact of sarcopenia on end-stage OA patients undergoing TKA are limited to two recent retrospective case-control studies, suggesting that patients with sarcopenia undergoing primary TKA have greater in-hospital length of stay, increased odds of 90-day medical complications, falls, lower extremity fractures, prosthetic joint infection and reoperations [25,26]. Frailty, a condition closely associated with sarcopenia, has also been linked to a higher rate of mortality, post-operative admission to the intensive care unit, discharge to institutional care and readmission in a recent population-based study of patients undergoing TKA [27].…”

End-stage knee osteoarthritis with and without sarcopenia and the effect of knee arthroplasty – a prospective cohort study

“…It has been widely accepted that TKA greatly increases social and physical aspects of quality of life [21][22][23][24]. Despite the common coprevalence of sarcopenia and OA, reports on the impact of sarcopenia on end-stage OA patients undergoing TKA are limited to two recent retrospective case-control studies, suggesting that patients with sarcopenia undergoing primary TKA have greater in-hospital length of stay, increased odds of 90-day medical complications, falls, lower extremity fractures, prosthetic joint infection and reoperations [25,26]. Frailty, a condition closely associated with sarcopenia, has also been linked to a higher rate of mortality, post-operative admission to the intensive care unit, discharge to institutional care and re-admission in a recent population-based study of patients undergoing TKA [27].…”