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Multicenter Study
. 2023 Jun:42:64-72.
doi: 10.1016/j.knee.2023.02.018. Epub 2023 Mar 11.

Sarcopenia is an independent risk factor for failure to achieve the 1-year MCID of the KOOS, JR and PROMIS PF-SF10a after TKA

Tyler J Humphrey  1 , Mehdi S Salimy  2 , Jeffrey M Jancuska  3 , Cameron R Egan  4 , Christopher M Melnic  5 , Kyle Alpaugh  6 , Hany S Bedair  7
Affiliations
Multicenter Study

Sarcopenia is an independent risk factor for failure to achieve the 1-year MCID of the KOOS, JR and PROMIS PF-SF10a after TKA

Tyler J Humphrey et al. Knee. 2023 Jun.

Abstract

Background: Sarcopenia, which is a progressive and multifactorial condition of decreased muscle strength, has been identified as an independent predictor for falls, revision, infection, and readmissions following total knee arthroplasty (TKA), but its association to patient reported outcomes (PROMs) is less studied. The aim of this study is to determine if sarcopenia and other measures of body composition are correlated with ability to achieve the 1-year minimal clinically important difference (MCID) of the KOOS JR and PROMIS-PF-SF10a following primary TKA.

Methods: A multicenter retrospective case-control study was performed. Inclusion criteria consisted of patients over the age of 18 undergoing primary TKA, body composition metrics determined by computed tomography (CT), and available pre- and post-operative PROM scores. Predictors of achievement of the 1-year MCID of the KOOS JR and PROMIS PF-SF-10a were determined through a multivariate linear regression.

Results: 140 primary TKAs met inclusion criteria. 74 (52.85%) patients achieved the 1-year KOOS, JR MCID and 108 (77.41%) patients achieved the 1-year MCID for the PROMIS PF-SF10a. Sarcopenia was independently associated with decreased odds of achieving the MCID of both the KOOS, JR (OR 0.31, 95%CI 0.10-0.97, p = 0.04) and the PROMIS-PF-SF10a (OR 0.32, 95%CI 0.12-0.85, p = 0.02) CONCLUSIONS: In our study, sarcopenia was independently associated with increased odds of failure to achieve the 1-year MCID of the KOOS, JR and PROMIS PF-SF10a after TKA. Early identification of sarcopenic patients may be beneficial for arthroplasty surgeons so that targeted nutritional counseling and exercises can be recommended prior to TKA.

Keywords: KOOS JR; MCID; PROMIS PF; Sarcopenia; TKA.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Authors Salimy MS, Jancuska JM, Egan C, Alpaugh K, and Humphrey TJ have no conflicts of interest to disclose. Author Melnic CM is a speaker and paid consultant for Smith & Nephew and receives research support from Zimmer Biomet. Author Bedair HS receives royalties from and is a paid consultant for Exactech and Smith & Nephew, has stock options in Exactech, receives research support from Zimmer Biomet, and receives royalties from Wolters Kluwer. These conflicts of interest are stated here but are unrelated to the present study.

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