Prevalence of sarcopenia indicators and sub-optimal protein intake among elective total joint replacement patients

Abstract

Sarcopenia is associated with falls, and can complicate recovery following total joint replacement (TJR) surgery. We examined: 1) the prevalence of sarcopenia indicators and lower-than-recommended protein intake among TJR patients and non-TJR community participants and 2) the relationships between dietary protein intake and sarcopenia indicators.
 
 We recruited adults ≥65 years of age who were undergoing TJR, and adults from the community not undergoing TJR (controls). We assessed grip strength and appendicular lean soft-tissue mass (ALSTMBMI) using DXA, and applied the original Foundation for the National Institutes of Health Sarcopenia Project cut-points for sarcopenia indicators (grip strength: <26kg for men and <16kg for women; ALSTM: <0.789m2 for men and <0.512m2 for women) and less conservative cut-points (grip strength: <31.83kg for men and <19.99kg for women; ALSTM: <0.725m2 for men and <0.591m2 for women). Total daily and per-meal protein intakes were derived from five-day diet records. 
 
 Sixty-seven participants (30 TJR, 37 controls) were enrolled. Using less conservative cut-points for sarcopenia, more control participants were weak compared to TJR participants (46% vs. 23%, p=0.055), and more TJR participants had low ALSTMBMI (40% vs. 13%, p=0.013). Approximately 70% of controls and 76% of TJR participants consumed <1.2g protein/kg/day (p=0.559). Total daily dietary protein intake was positively associated with grip strength (r=0.44, p=0.001) and ALSTMBMI (r=0.29, p=0.03).
 
 Using less conservative cut-points, low ALSTMBMI, but not weakness, was more common in TJR patients. Both groups may benefit from a dietary intervention to increase protein intake, which may improve surgical outcomes in TJR patients.