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Sarcopenia: an unsolved problem after hip fracture

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Abstract

Introduction

Sarcopenia, loss of muscle mass and strength, leads to functional dependence and disability. To date, no study reported the postoperative change of sarcopenia prevalence after hip fractures. Thus, we assessed postoperative changes in the prevalence of osteoporosis and sarcopenia in hip fracture patients.

Materials and methods

Among 1159 patients, who underwent surgery for low-energy hip fractures between May 2012 and December 2019, 224 patients (38 men and 186 women with a mean age of 76.8 ± 8.7 years) were studied with preoperative and follow-up dual-energy X-ray absorptiometry (DXA). Bone mineral density (BMD) and skeletal muscle mass were measured on DXA scans. The postoperative changes in the prevalence of osteoporosis and that of the sarcopenia were evaluated as well as Koval grade of the hip fracture patients.

Results

While there was no significant change in BMD, SMI significantly decreased postoperatively. Mean decrease of the SMI was 0.53 kg/m2 in men and 0.38 kg/m2 in women. Prevalence of sarcopenia increased from 63 to 89% (p = 0.014) in men and from 45 to 57% (p = 0.006) in women. Lower BMI (Odds ratio (OR) 0.85 (95% confidence interval (CI) 0.76–0.96), p = 0.008) and prior sarcopenia (OR 14.47 (95% CI 5.29–35.39), p < 0.001) were the risk factors for the decrease of SMI after hip fracture.

Conclusions

After hip fracture, osteoporosis seemed to be well managed and the prevalence of osteoporosis did not increase. However, SMI decreased and the prevalence of sarcopenia increased. More active measures are warranted to prevent sarcopenia in elderly hip fracture patients.

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Acknowledgements

Jung-Wee Park and Hong-Seok Kim equally contributed to this work and should be considered co-first authors.

Funding

This research was supported by a grant from the Korean Health Technology Research and Development Project through the Korean Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI19C0481, HC20C0157).

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Authors and Affiliations

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

    Jung-Wee Park, Young-Kyun Lee & Kyung-Hoi Koo

  2. Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea

    Hong-Seok Kim

  3. Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, South Korea

    Young-Kyun Lee & Kyung-Hoi Koo

  4. Department of Orthopaedic Surgery, Gyeongsang National University Hospital, Jinju, South Korea

    Jun-Il Yoo

  5. Department of Orthopaedic Surgery, Chung-Ang University Hospital, Seoul, South Korea

    Yangseon Choi

  6. Department of Orthopaedic Surgery, Seoul Bumin Hospital, 389 Gonghang-daero, Gangseo-gu, Seoul, 07590, South Korea

    Yong-Chan Ha

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  1. Jung-Wee Park
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Contributions

J-WP wrote the manuscript. H-SK acquired the patient data. Y-KL revised the manuscript. J-IY performed statistical analysis. YC prepared the illustration. Y-CH conceived the concept and methodology of the study. K-HK supervised the study.

Corresponding author

Correspondence to Yong-Chan Ha.

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Conflict of interest

Jung-Wee Park, Hong-Seok Kim, Young-Kyun Lee, Jun-Il Yoo, Yangseon Choi, Yong-Chan Ha, Kyung-Hoi Koo declare that they have no conflict of interest.

Ethical approval

The study design and protocol were approved by the institutional review board of Chung-Ang University Hospital (IRB No. 2108-012-19379). Written informed consent was waived for all patients involved in this study.

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Park, JW., Kim, HS., Lee, YK. et al. Sarcopenia: an unsolved problem after hip fracture. J Bone Miner Metab 40, 688–695 (2022). https://doi.org/10.1007/s00774-022-01334-6

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