The impact of sarcopenic obesity on knee and hip osteoarthritis: a scoping review

Godziuk, Kristine; Prado, Carla M.; Woodhouse, Linda J.; Forhan, Mary

doi:10.1186/s12891-018-2175-7

Cited by 82 publications

(58 citation statements)

References 77 publications

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“…One important difference between the current study and the previous researches on sarcopenia with surgery is that those surgeries mainly induce a catabolic status in the patients while knee arthroplasty induces catabolism in early phase followed by anabolism due to patient regaining their mobility and ability to exercise. This phenomenon could also be a possible explanation of the signi cant improvement of lean mass in overweight or obese sarcopenic female in our study as they lost fat and weight during the initial catabolism after arthroplasty and built up muscle, made possible by better walking ability and less bodyweight hindering movement, during their subsequent rehabilitation [20,35,43]. In essence, knee arthroplasty helps break the vicious cycle of immobility, obesity and sarcopenia by returning these individuals to normal lower limb function.…”

Section: Discussionmentioning

confidence: 56%

“…The total reduction in energy expenditure, together with ageing-related gains in adipose tissue lead to many patients developed overweight or even obesity. The excess load will further exacerbate their knee OA progression, and it is the combination of these factors that been regarded to create and perpetuate a vicious cycle between obesity, sarcopenia and osteoarthritis [20,21].…”

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confidence: 99%

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End-stage knee osteoarthritis with and without sarcopenia – and the effect of knee arthroplasty

Ho¹,

Lau²,

Chau³

et al. 2020

Preprint

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Background Sarcopenia often accompanies osteoarthritis but the relationship between them is still unclear and no strong consensus can be reached. Previous studies revealed that OA in the hip or knee is associated with declines in muscle mass and strength. This study aims to examine the status of sarcopenia in individuals with symptomatic end-stage OA of the knee, the effect of this condition on their peri-operative TKA rehabilitation and functional outcome. Methods This prospective study was conducted between 2015 to 2018 at our hospital. Patients with end-stage osteoarthritis of the knee on queue for total knee arthroplasty were recruited into the study. Primary outcome measures were DEXA in lean muscle mass, muscle strength, knee motion and function. Secondary outcomes measures were Quality of Life (QOL) measurements in pain, psychological and physical health. Results Fifty-eight patients were recruited, of which 79.3% were female and 32.8% already had sarcopenia at baseline. The average age of sarcopenic subjects and non-sarcopenic subjects were comparable (67.89±7.07 vs. 67.92±6.85; p=0.99) but sarcopenic subjects tend to have lower BMI (25.64±2.64 vs. 28.57±4.04; p=0.01). There was a statistically significant improvement in walking speed and range of movement in both sarcopenic and non-sarcopenic patients after TKA (p<0.01). This was accompanied by an improvement trend in muscle mass in all subjects. A sarcopenic female that were overweight or obese had statistically significant improvement in both Appendage Lean Mass Index and Lean Mass Index after total knee arthroplasties in 12 months (p=0.04). There was no change in handgrip power before and after TKA and subsequent follow-up (p=0.97). Quality of life measured with WOMAC, SF12v2 and IPAQ revealed progressive significant improvement (p≤0.01). Further analysis at the IPAQ also found increased engagement of high-intensity activities. Conclusions To conclude, our study showed that sarcopenia among patients with end-stage OA of the knee is not uncommon. The mechanical mal-alignment and degenerative process in OA of the knee can be corrected with TKA. However, the rehabilitation and recovery in the elderly population may never fully recover. Further studies focusing on this group of patient and employment of multimodal therapy with a supervised exercise program is warranted.

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Section: Discussionmentioning

confidence: 56%

mentioning

confidence: 99%

End-stage knee osteoarthritis with and without sarcopenia – and the effect of knee arthroplasty

Ho¹,

Lau²,

Chau³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…One important difference between the current study and the previous researches on sarcopenia with surgery is that those surgeries mainly induce a catabolic status in the patients while knee arthroplasty induces catabolism in early phase followed by anabolism due to patient regaining their mobility and ability to exercise. This phenomenon may potentially explain the improvement of lean mass in overweight or obese sarcopenic female in our study as they lost fat and weight during the initial catabolism after arthroplasty and built up muscle, made possible by better walking ability and less bodyweight hindering movement, during their subsequent rehabilitation [19,38,44]. However, the nding is limited by the small scale of our study and further studies with larger sample sizes are warranted to validate this relationship.…”

Section: Discussionmentioning

confidence: 76%

“…In turn the subsequent reduction in energy expenditure, together with ageing-related gains in adipose tissue lead to these patients developed overweight or even obesity. This increased load would further exacerbate their knee OA progression, and it is the combination of these factors that have been regarded to create and perpetuate a vicious cycle between obesity, sarcopenia and osteoarthritis [19,20].…”

Section: Introductionmentioning

confidence: 99%

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

Lau

Chau

et al. 2020

Preprint

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Background: Sarcopenia often accompanies osteoarthritis (OA) which is managed by total knee arthroplasty (TKA) in late stage. Recent studies have suggested higher risk of post-operative complication after TKA in sarcopenic OA subjects but whether TKA can benefit them as for non-sarcopenic subjects remain unexplored. This study aims to examine the dynamic, mutual impact of sarcopenia and TKA in their one-year post-operative period.Methods: This prospective cohort study was conducted between 2015 to 2018 at our hospital. Patients with end-stage OA of the knee waiting for TKA were recruited into the study. Primary outcome measures were change in muscle strength, mass and function. Secondary outcome measures were Quality of Life (QOL) measurements in pain, psychological and physical health.Results: Fifty-eight patients were recruited, of which 79.3% were female and 32.8% already had sarcopenia at baseline. The average age of sarcopenic subjects and non-sarcopenic subjects were comparable (67.89±7.07 vs. 67.92±6.85; p=0.99) and sarcopenic subjects had lower body mass index (BMI) (25.64±2.64 vs. 28.57±4.04; p=0.01). There was a statistically significant improvement in walking speed (10.24±5.35 vs 7.69±2.68, p<0.01) and muscle strength in both sarcopenic and non-sarcopenic patients after TKA. This was accompanied by an improvement trend in muscle mass in all subjects. There was no change in handgrip power before and after TKA and subsequent follow-up (p=0.97). Quality of life measured with WOMAC, SF12v2 and IPAQ revealed progressive significant improvement (p≤0.01). Further analysis at the IPAQ also found increased engagement of high-intensity activities.Conclusions: This study showed that sarcopenia among patients with end-stage OA of the knee is not uncommon but both sarcopenic and non-sarcopenic OA patients could reach significant clinical and functional improvement after TKA. Further studies with increased sample size and different ethnicities can help ascertain a beneficial role of TKA on sarcopenic OA subjects.

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“…A higher BMI in women and men with knee osteoarthritis could therefore be an explanation for the lower risk for hip fracture we found in the period before TKR. However, obesity is an inflammatory condition with an increased risk for type 2 diabetes and cardiovascular disease, and low muscle mass and low physical performance are associated with obesity [27,29]. These are all risk factors for hip fracture, and abdominal obesity have been associated with an increased risk for hip fracture [28,[30][31][32][33].…”

Section: Bmd Bmi Falls and Fracturementioning

confidence: 99%

Risk for hip fracture before and after total knee replacement in Sweden

et al. 2019

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We studied the risk for hip fracture before and after total knee replacement (TKR) in the entire population in Sweden. Women and men had a low risk for hip fracture before TKR but an increased risk the first year after TKR. Purpose It is known that osteoarthritis is associated with high bone mass. We therefore studied the risk of hip fracture before and after total knee replacement (TKR), risk of different hip fracture types, and risk subdivided in genders and age groups. Methods We followed the total Swedish population born between 1902 and 1952 (n = 4,258,934) during the period 1987-2002 and identified all patients with TKR due to primary OA (n = 39,291), and all patients with hip fracture (n = 195,860) in the Swedish National Inpatient Register. The risk time analyses were based on Poisson regression models. Results The hazard ratio (HR) for hip fracture the last year before TKR was 0.86 (95% CI 0.74 to 1.00) and the first year after 1.26 (95% CI 1.11 to 1.42) compared to individuals without TKR. The HR for femoral neck fracture 0-10 years after TKR was 0.95 (95% CI 0.89 to 1.01) and for trochanteric fracture was 1.13 (95% CI 1.06 to 1.21). The HR for hip fracture in the age group 50-74 was 1.28 (95% CI 1.14 to 1.43) and in the age group 75-90 years was 0.99 (95% CI 0.94 to 1.04) 0-10 years after TKR, compared to individuals without TKR. Conclusion Individuals had a low risk for hip fracture before TKR but an increased risk the first year after TKR. The risk in individuals below age 75 years and for trochanteric fractures was increased after TKR. Possible explanations include changed knee kinematics after a TKR, physical activity level, fall risk, and other unknown factors.

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The impact of sarcopenic obesity on knee and hip osteoarthritis: a scoping review

Cited by 82 publications

References 77 publications

End-stage knee osteoarthritis with and without sarcopenia – and the effect of knee arthroplasty

End-stage knee osteoarthritis with and without sarcopenia – and the effect of knee arthroplasty

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

Risk for hip fracture before and after total knee replacement in Sweden

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