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Sarcopenia: an unsolved problem after hip fracture.

Jung-Wee Park¹, Hong-Seok Kim², Young-Kyun Lee^1,3

¹Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Songnam, South Korea.

Journal of Bone and Mineral Metabolism

|May 31, 2022

Summary

Hip fracture surgery patients experienced a significant increase in sarcopenia prevalence, despite stable bone mineral density. This highlights the need for proactive strategies to combat muscle loss in elderly patients post-fracture.

Keywords:

Dual energy X-ray absorptiometry Hip fracture Osteoporosis Sarcopenia

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Area of Science:

Gerontology
Orthopedics
Geriatric Medicine

Background:

Sarcopenia, characterized by loss of muscle mass and strength, contributes to functional decline and disability in the elderly.
Hip fractures are a common cause of morbidity and mortality in older adults, often leading to reduced mobility.
Postoperative changes in sarcopenia prevalence following hip fractures have not been extensively studied.

Purpose of the Study:

To investigate the changes in the prevalence of osteoporosis and sarcopenia after hip fracture surgery.
To evaluate the impact of hip fracture on skeletal muscle mass and bone mineral density.

Main Methods:

A cohort of 224 hip fracture patients (mean age 76.8 years) underwent preoperative and follow-up dual-energy X-ray absorptiometry (DXA).
DXA scans were utilized to measure bone mineral density (BMD) and skeletal muscle mass index (SMI).
Postoperative changes in osteoporosis and sarcopenia prevalence were assessed, along with Koval grade.

Main Results:

While BMD remained stable, skeletal muscle mass index (SMI) significantly decreased postoperatively (mean decrease: 0.53 kg/m² in men, 0.38 kg/m² in women).
The prevalence of sarcopenia increased substantially, from 63% to 89% in men (p=0.014) and 45% to 57% in women (p=0.006).
Lower BMI and pre-existing sarcopenia were identified as risk factors for SMI decrease after hip fracture.

Conclusions:

Osteoporosis prevalence remained stable and appeared well-managed post-hip fracture surgery.
There was a significant decline in skeletal muscle mass and a corresponding increase in sarcopenia prevalence.
Implementing proactive measures is crucial to prevent and manage sarcopenia in elderly patients recovering from hip fractures.