Analysis of influence of sarcopenia on early postoperative function of femoral neck fracture by hip arthroplasty

Abstract

To determine the association of sarcopenia with short-term postoperative function after hip replacement for femoral neck fractures. A prospective study of 181 consecutive patients with femoral neck fractures who underwent hip replacement from May 2014 to January 2017 were performed, including 58 males and 123 females aging from 53 to 92 years old. The general conditions were collected before surgery, skeletal muscle index(ASMI), handgrip strength were measured. Clinical outcomes were followed up including postoperative complications, time of on-site, Harris score (postoperative 2 weeks, 3, 6 months), hospitalization costs, and hospital stay. According to handgrip strength and ASMI, the patients were divided into the sarcopina group and the non-sarcopina group; according to the Harris score at the 6-month follow-up, the patients were divided into good prognosis group and poor prognosis group. Univariate analysis and binary logistic regression analysis were used to investigate whether sarcopenia was a risk factor for poor postoperative hip joint surgery. All patients were followed up at 2 weeks, 3 and 6 months, postoperative early complication included wound infection in 16 cases, thrombus of lower extremity veins in 14 cases, no dislocation, prosthetic loosening and prosthesis related infections occurred. Sarcopenia was present in 82 of 181 patients(45%), Compared with non-sarcopenic patients, sarcopenic patients had a higher risk of postoperative complications, longer postoperative hospital stay, more hospital costs and lower harris scores. In Binary logistic analysis revealed that sarcopenia(P=0.08), hemiarthroplasty(P<0.001), diabetes(P=0.016) and infection(P=0.018) were important predictors of unsatisfactory postoperative function. Sarcopenia is an important predictor of poor postoperative prognosis in patients with femoral neck fractures after hip replacement. The treatment for sarcopenia maybe an important way to protect patients with femoral neck fractures from poor prognosis after hip replacement.