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

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kevin Ki-Wai Ho ◽  
Lawrence Chun-Man Lau ◽  
Wai-Wang Chau ◽  
Queena Poon ◽  
Kwong-Yin Chung ◽  
...  
Keyword(s):  
Cohort Study ◽  
Muscle Strength ◽  
Outcome Measures ◽  
Prospective Cohort Study ◽  
Knee Arthroplasty ◽  
Prospective Cohort ◽  
Secondary Outcome ◽  
Link Type ◽  
End Stage

Abstract Background Sarcopenia often accompanies osteoarthritis (OA), which is managed by total knee arthroplasty (TKA) in the late stage. Recent studies have suggested a higher risk of post-operative complications after TKA in sarcopenic OA subjects, but whether TKA can benefit them similar to non-sarcopenic subjects remains unexplored. This study aimed to examine the dynamic, mutual impact of sarcopenia and TKA in a 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 for 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 was comparable (67.89 ± 7.07 vs. 67.92 ± 6.85; p = 0.99), but sarcopenic subjects had a 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 (19.31 ± 5.92 vs. 18.98 ± 6.37 vs. 19.36 ± 7.66; p = 0.97). QOL measured before, after and at follow-up with WOMAC (total: 42.27 ± 15.98 vs. 20.65 ± 15.24 vs. 16.65 ± 18.13) and SF12v2 (PCS: 33.06 ± 8.55 vs. 38.96 ± 8.01 vs. 40.67 ± 7.93) revealed progressive significant improvement (both comparisons p ≤ 0.01). Further analysis with 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 achieved significant clinical and functional improvement after TKA. Further studies with a larger sample size and different ethnicities could help ascertain a beneficial role of TKA in sarcopenic OA subjects. Trial registration Registry: ClinicalTrials.gov, Registration number: NCT03579329. Date of registration: 6 July 2018. Retrospectively registered.

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

2020 ◽  
Author(s):  
Kevin Ki-Wai Ho ◽  
Lawrence Chun-Man Lau ◽  
Wai Wang Chau ◽  
Queena Poon ◽  
Kwong-Yin Chung ◽  
...  
Keyword(s):  
Cohort Study ◽  
Muscle Strength ◽  
Outcome Measures ◽  
Prospective Cohort Study ◽  
Knee Arthroplasty ◽  
Prospective Cohort ◽  
Functional Improvement ◽  
Secondary Outcome ◽  
End Stage

Abstract Background: Sarcopenia often accompanies osteoarthritis (OA), which is managed by total knee arthroplasty (TKA) in the late stage. Recent studies have suggested a higher risk of post-operative complications after TKA in sarcopenic OA subjects, but whether TKA can benefit them similar to non-sarcopenic subjects remains unexplored. This study aimed to examine the dynamic, mutual impact of sarcopenia and TKA in a 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 for 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 was comparable (67.89±7.07 vs. 67.92±6.85; p=0.99), but sarcopenic subjects had a 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 (19.31±5.92 vs. 18.98±6.37 vs. 19.36±7.66; p=0.97). QOL measured before, after and at follow-up with WOMAC (total: 42.27±15.98 vs. 20.65±15.24 vs. 16.65±18.13) and SF12v2 (PCS: 33.06±8.55 vs. 38.96±8.01 vs. 40.67±7.93) revealed progressive significant improvement (both comparisons p≤0.01). Further analysis with 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 achieved significant clinical and functional improvement after TKA. Further studies with a larger sample size and different ethnicities could help ascertain a beneficial role of TKA in sarcopenic OA subjects.

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

2020 ◽  
Author(s):  
Kevin Ki-Wai Ho ◽  
Lawrence Chun-Man Lau ◽  
Wai Wang Chau ◽  
Queena Poon ◽  
Kwong-Yin Chung ◽  
...  
Keyword(s):  
Cohort Study ◽  
Muscle Strength ◽  
Outcome Measures ◽  
Prospective Cohort Study ◽  
Knee Arthroplasty ◽  
Prospective Cohort ◽  
Functional Improvement ◽  
Secondary Outcome ◽  
End Stage

Abstract Background:Sarcopenia often accompanies osteoarthritis (OA), which is managed by total knee arthroplasty (TKA) in the late stage. Recent studies have suggested a higher risk of post-operative complications after TKA in sarcopenic OA subjects, but whether TKA can benefit them similar to non-sarcopenic subjects remains unexplored. This study aimed to examine the dynamic, mutual impact of sarcopenia and TKA in a 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 for 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 was comparable (67.89±7.07 vs. 67.92±6.85; p=0.99), but sarcopenic subjects had a 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 (19.31±5.92 vs. 18.98±6.37 vs. 19.36±7.66; p=0.97). QOL measured before, after and at follow-up with WOMAC (total: 42.27±15.98 vs. 20.65±15.24 vs. 16.65±18.13) and SF12v2 (PCS: 33.06±8.55 vs. 38.96±8.01 vs. 40.67±7.93) revealed progressive significant improvement (both comparisons p≤0.01). Further analysis with 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 achieved significant clinical and functional improvement after TKA. Further studies with an larger sample size and different ethnicities could help ascertain a beneficial role of TKA in sarcopenic OA subjects.

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

2020 ◽  
Author(s):  
Kevin Ki-Wai Ho ◽  
Lawrence Chun-Man Lau ◽  
Wai Wang Chau ◽  
Queena Poon ◽  
Kwong-Yin Chung ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cohort Study ◽  
Muscle Strength ◽  
Outcome Measures ◽  
Prospective Cohort Study ◽  
Knee Arthroplasty ◽  
Prospective Cohort ◽  
Secondary Outcome ◽  
End Stage

Abstract 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.

scholarly journals Meniscal tear outcome Study (METRO Study): a study protocol for a multicentre prospective cohort study exploring the factors which affect outcomes in patients with a meniscal tear

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e038681
Author(s):  
Imran Ahmed ◽  
Mike Bowes ◽  
Charles E Hutchinson ◽  
Nicholas Parsons ◽  
Sophie Staniszewska ◽  
...  
Keyword(s):  
Cohort Study ◽  
Research Ethics ◽  
Outcome Measures ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Meniscal Tear ◽  
Ethics Committee ◽  
Secondary Outcome ◽  
Research Ethics Committee ◽  
Baseline Characteristics

IntroductionThis study is designed to explore the baseline characteristics of patients under 55 years of age with a meniscal tear, and to describe the relationship between the baseline characteristics and patient-reported outcome measures (PROMs) over 12 months. Research has highlighted the need for a trial to investigate the effectiveness of arthroscopic meniscectomy in younger patients. Before this trial, we need to understand the patient population in greater detail.Methods and analysisThis is a multicentre prospective cohort study. Participants aged between 18 and 55 years with an MRI confirmed meniscal tear are eligible for inclusion. Baseline characteristics including age, body mass index, gender, PROMs duration of symptoms and MRI will be collected. The primary outcome measure is the Western Ontario Meniscal Evaluation Tool at 12 months. Secondary outcome measures will include PROMs such as EQ5D, Knee Injury and Osteoarthritis Outcome Score and patient global impression of change score at 3, 6 and 12 months.Ethics and disseminationThe study obtained approval from the National Research Ethics Committee West Midlands—Black Country research ethics committee (19/WM/0079) on 12 April 2019. The study is sponsored by the University of Warwick. The results will be disseminated via peer-reviewed publication.Trial registration numberUHCW R&D Reference: IA428119. University of Warwick Sponsor ID: SC.08/18–19

scholarly journals Biomarkers for length of hospital stay, changes in muscle mass, strength and physical function in older medical patients: protocol for the Copenhagen PROTECT study—a prospective cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e042786
Author(s):  
Rikke S Kamper ◽  
Martin Schultz ◽  
Sofie K Hansen ◽  
Helle Andersen ◽  
Anette Ekmann ◽  
...  
Keyword(s):  
Body Composition ◽  
Cohort Study ◽  
Muscle Strength ◽  
Physical Function ◽  
Muscle Mass ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Medical Patients ◽  
Link Type ◽  
Protect Study

IntroductionSarcopenia is generally used to describe the age-related loss of muscle mass and strength believed to play a major role in the pathogenesis of physical frailty and functional impairment that may occur with old age. The knowledge surrounding the prevalence and determinants of sarcopenia in older medical patients is scarce, and it is unknown whether specific biomarkers can predict physical deconditioning during hospitalisation. We hypothesise that a combination of clinical, functional and circulating biomarkers can serve as a risk stratification tool and can (i) identify older acutely ill medical patients at risk of prolonged hospital stays and (ii) predict changes in muscle mass, muscle strength and function during hospitalisation.Method and analysisThe Copenhagen PROTECT study is a prospective cohort study consisting of acutely ill older medical patients admitted to the acute medical ward at Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark. Assessments are performed within 24 hours of admission and include blood samples, body composition, muscle strength, physical function and questionnaires. A subgroup of patients transferred to the Geriatric Department are included in a smaller geriatric cohort and have additional assessments at discharge to evaluate the relative change in circulating biomarker concentrations, body composition, muscle strength and physical function during hospitalisation. Enrolment commenced 4 November 2019, and proceeds until August 2021.Ethics and disseminationThe study protocol has been approved by the local ethics committee of Copenhagen and Frederiksberg (H-19039214) and the Danish Data Protection Agency (P-2019-239) and all experimental procedures were performed in accordance with the Declaration of Helsinki. Findings from the project, regardless of the outcome, will be published in relevant peer-reviewed scientific journals in online (www.clinicaltrials.gov).Trial registration numberNCT04151108

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