Abstract
BackgroundThe progressive, debilitating nature of knee and hip osteoarthritis can result in severe, persistent pain and disability, potentially leading to a need for total joint arthroplasty (TJA) in end-stage osteoarthritis. TJA in adults with obesity is associated with increased surgical risk and prolonged recovery, yet classifying obesity only using body mass index (BMI) precludes distinction of obesity phenotypes and their impact on surgical risk and recovery. The sarcopenic obesity phenotype, characterized by high adiposity and low skeletal muscle mass, is associated with higher infection rates, poorer function, and slower recovery after surgery in other clinical populations, but not thoroughly investigated in osteoarthritis. The rising prevalence and impact of this phenotype demands further attention in osteoarthritis treatment models of care, particularly as osteoarthritis-related pain, disability, and current treatment practices may inadvertently be influencing its development.MethodsA scoping review was used to examine the extent of evidence of sarcopenic obesity in adults with hip or knee osteoarthritis. Medline, CINAHL, Web of Science and EMBASE were systematically searched from inception to December 2017 with keywords and subject headings related to obesity, sarcopenia and osteoarthritis.ResultsEleven studies met inclusion criteria, with indications that muscle weakness, low skeletal muscle mass or sarcopenia are present alongside obesity in this population, potentially impacting therapeutic outcomes, and TJA surgical risk and recovery.ConclusionsConsideration of sarcopenic obesity should be included in osteoarthritis patient assessments.
Highlights
The progressive, debilitating nature of knee and hip osteoarthritis can result in severe, persistent pain and disability, potentially leading to a need for total joint arthroplasty (TJA) in end-stage osteoarthritis
Surgical replacement of articular joint components, called a total joint arthroplasty (TJA), is currently the most effective treatment for severe pain and disability associated with end-stage knee or hip osteoarthritis that ceases to respond to other therapeutic interventions
CINAHL, Web of Science and Embase databases were searched from inception to December 2017 using medical subject heading (MeSH) terms and keywords related to osteoarthritis, obesity, and sarcopenia
Summary
The progressive, debilitating nature of knee and hip osteoarthritis can result in severe, persistent pain and disability, potentially leading to a need for total joint arthroplasty (TJA) in end-stage osteoarthritis. In Canada, volumes are lower but the accrual rate tripled from 42,000 patients in 2000 [6] to 117,000 patients in 2016 [7], and similar persistent growth is apparent throughout Europe [8] This increased demand is outpacing the supply of TJA, leading to longer wait times and pressure on health care systems to reduce delays in accessing care. Evidence-based guidelines for surgical appropriateness are lacking, resulting in a reliance on clinical judgement [9] This has led to subjectivity in risk stratification, conflicting approaches and barriers or Godziuk et al BMC Musculoskeletal Disorders (2018) 19:271 delays in treatment access for patients with obesity due to evidence of increased surgical risk
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
