Sarcopenia Is Associated with an Increased Risk of Postoperative Complications Following Total Hip Arthroplasty for Osteoarthritis

Abstract

Sarcopenia is a state of catabolic muscle wasting prevalent in geriatric patients. Likewise, osteoarthritis is an age-related musculoskeletal disease affecting patients with similar demographics. Late-stage hip osteoarthritis is often treated with total hip arthroplasty (THA). As sarcopenia influences the surgical outcomes, this study aimed to assess the impact of sarcopenia on the outcomes of THA. A 1:3 matched case–control study of sarcopenic to control patients was performed using a large national database. In total, 3992 patients were analyzed. Sarcopenic patients undergoing THA were more likely to experience dislocation (odds ratio (OR) = 2.19, 95% confidence interval (CI) 1.21–3.91) within 1 year of THA. Furthermore, sarcopenic patients had higher urinary tract infection rates (OR = 1.79, CI 1.32–2.42) and a greater risk of 90-day hospital readmission (hazard ratio (HR) = 1.39, CI 1.10–1.77). Sarcopenic patients experienced more falls (OR = 1.62, CI 1.10–2.39) and fragility fractures (OR = 1.77, CI 1.34–2.31). Similarly, sarcopenic patients had higher day of surgery costs (USD 13,534 vs. USD 10,504) and 90-day costs (USD 17,139 vs. USD 13,394) compared with the controls. Ultimately, sarcopenic patients undergoing THA experience higher rates of postoperative complications and incur greater medical costs. Given the potential risks, orthopedic surgeons may consider treating or reducing the severity of sarcopenia before surgery.

Keywords

• hip
• arthroplasty
• sarcopenia
• complications
• readmission