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Background <p>Sarcopenia is increasingly recognized as a significant factor influencing postoperative outcomes in orthopedic procedures. This study aimed to systematically evaluate the impact of sarcopenia on clinical outcomes in patients undergoing total knee arthroplasty (TKA) for knee osteoarthritis (KOA), specifically focusing on knee function, quality of life, and complications.</p> Methods <p>We conducted a comprehensive search on PubMed, Embase, and CENTRAL platforms, to identify eligible studies comparing clinical outcomes of sarcopenic and non-sarcopenic patients undergoing primary TKA for KOA. Heat map was generated to intuitively illustrate the statistical differences in various clinical outcomes between sarcopenia and non-sarcopenia patients. Meta analyses were also performed to compare the outcomes between groups with and without sarcopenia using mean difference (MD) or risk ratio (RR) as the effect sizes.</p> Results <p>Our systematic review and meta-analysis of 10 studies involving 93,440 patients revealed that sarcopenia was associated with worse post-TKA outcomes. Sarcopenic patients experienced significantly higher blood transfusion requirements (RR = 3.66, 95% CI: 2.86–4.69, <i>p</i> &lt; 0.001), and a higher risk of overall complications (RR = 1.80, 95% CI: 1.53–2.11, <i>p</i> &lt; 0.001). Knee function, as measured by the WOMAC and KOOS scores, was inferior in early period (≤ 6months) in sarcopenic patients, but no significant differences were observed at 12 months. There is a consensus leans towards no difference in knee pain between the two groups. Sarcopenic patients showed slower walking speeds and increased fall risk.</p> Conclusions <p>Preliminary finding was obtained that sarcopenia was associated with increased transfusion needs, higher complication risks, and delayed functional recovery, in patients undergoing TKA for KOA. To optimize postoperative outcomes, it is crucial to address sarcopenia in the preoperative and postoperative management, with a call for more prospective, high-quality research to solidify these findings.</p>

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Impact of sarcopenia on clinical outcomes of older adults undergoing total knee arthroplasty for osteoarthritis: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月31日

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  • Xiao-yu Zhang,
  • Xin Zhou,
  • Jin-chang Han,
  • Si Wu,
  • Xiao-qing Zhang,
  • Qing-Tong Cui,
  • Peng-tao Huang,
  • Yun-yan Cai,
  • Chao Zhang,
  • Ai-feng Liu

摘要

Background

Sarcopenia is increasingly recognized as a significant factor influencing postoperative outcomes in orthopedic procedures. This study aimed to systematically evaluate the impact of sarcopenia on clinical outcomes in patients undergoing total knee arthroplasty (TKA) for knee osteoarthritis (KOA), specifically focusing on knee function, quality of life, and complications.

Methods

We conducted a comprehensive search on PubMed, Embase, and CENTRAL platforms, to identify eligible studies comparing clinical outcomes of sarcopenic and non-sarcopenic patients undergoing primary TKA for KOA. Heat map was generated to intuitively illustrate the statistical differences in various clinical outcomes between sarcopenia and non-sarcopenia patients. Meta analyses were also performed to compare the outcomes between groups with and without sarcopenia using mean difference (MD) or risk ratio (RR) as the effect sizes.

Results

Our systematic review and meta-analysis of 10 studies involving 93,440 patients revealed that sarcopenia was associated with worse post-TKA outcomes. Sarcopenic patients experienced significantly higher blood transfusion requirements (RR = 3.66, 95% CI: 2.86–4.69, p < 0.001), and a higher risk of overall complications (RR = 1.80, 95% CI: 1.53–2.11, p < 0.001). Knee function, as measured by the WOMAC and KOOS scores, was inferior in early period (≤ 6months) in sarcopenic patients, but no significant differences were observed at 12 months. There is a consensus leans towards no difference in knee pain between the two groups. Sarcopenic patients showed slower walking speeds and increased fall risk.

Conclusions

Preliminary finding was obtained that sarcopenia was associated with increased transfusion needs, higher complication risks, and delayed functional recovery, in patients undergoing TKA for KOA. To optimize postoperative outcomes, it is crucial to address sarcopenia in the preoperative and postoperative management, with a call for more prospective, high-quality research to solidify these findings.