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Observational Study
. 2024 Jan 20;25(1):78.
doi: 10.1186/s12891-024-07210-w.

The impact of primary total hip and knee replacement on frailty: an observational prospective analysis

Tobias Kappenschneider  1 , Philip Bammert  2 , Günther Maderbacher  3 , Felix Greimel  3 , Lukas Parik  3 , Dominik Emanuel Holzapfel  3 , Amadeus Dominik Schraag  3 , Julia Götz  3 , Katrin Michalk  3 , Joachim Grifka  3 , Matthias Meyer  3
Affiliations
Observational Study

The impact of primary total hip and knee replacement on frailty: an observational prospective analysis

Tobias Kappenschneider et al. BMC Musculoskelet Disord. .

Abstract

Background: Osteoarthritis is a prevalent condition in frail older adults that requires hip or knee replacement in many patients. The aim of the study was to determine the impact of hip and knee arthroplasty on frailty.

Methods: In this prospective short-term study, we used data from 101 participants of the ongoing Special Orthopaedic Geriatrics (SOG) trial, funded by the German Federal Joint Committee (GBA). Frailty, measured by Fried's Physical Frailty Phenotype (PFP), was assessed preoperatively, 7 days postoperatively, 4-6 weeks and 3 months after hip and knee arthroplasty. ANOVA with repeated measures and post-hoc tests for the subgroups were used for the statistical analysis.

Results: Of the 101 participants, 50 were pre-frail (1-2 PFP criteria) and 51 were frail (≥ 3 PFP criteria) preoperatively. In the pre-frail group, the PFP score decreased from 1.56 ± 0.50 (median 2) preoperatively to 0.53 ± 0.73 (median 0) 3 months after surgery (p < 0.001). The PFP score in the frail cohort decreased from 3.39 ± 1.45 (median 3) preoperatively to 1.27 ± 1.14 (median 1) 3 months postoperatively (p < 0.001). While the PFP score of the pre-frail participants increased 7 days after surgery, the PFP score of the frail group decreased significantly.

Conclusion: Pre-frail individuals often regain robustness and patients with frailty are no longer assessed as frail after surgery. Joint replacement is an effective intervention to improve frailty in hip and knee osteoarthritis.

Trial registration: This study is part of the Special Orthopaedic Geriatrics (SOG) trial, German Clinical Trials Register DRKS00024102. Registered on 19 January 2021.

Keywords: Frailty; Hip arthroplasty; Knee arthroplasty; Older people; Orthogeriatric.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Physical Frailty Phenotype scores (means) of the total study group (n = 101), the pre-frail group (n = 50) and the frail group (n = 51) at the four different measurement points of the study
Fig. 2
Fig. 2
Box plots of the frailty scores according to Fried’s phenotype of the pre-frail groups pre- and postoperatively
Fig. 3
Fig. 3
Box plots of the frailty scores according to Fried’s Phenotype of the frail groups pre- and postoperatively
See this image and copyright information in PMC

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References

    1. Hoogendijk EO, Afilalo J, Ensrud KE, Kowal P, Onder G, Fried LP. Frailty: implications for clinical practice and public health. Lancet. 2019;394(10206):1365–75. doi: 10.1016/S0140-6736(19)31786-6. - DOI - PubMed
    1. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013;381(9868):752–62. doi: 10.1016/S0140-6736(12)62167-9. - DOI - PMC - PubMed
    1. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA, Cardiovascular Health Study Collaborative Research Group Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56. doi: 10.1093/gerona/56.3.M146. - DOI - PubMed
    1. Cesari M, Prince M, Thiyagarajan JA, De Carvalho IA, Bernabei R, Chan P, Gutierrez-Robledo LM, Michel JP, Morley JE, Ong P, Rodriguez Manas L, Sinclair A, Won CW, Beard J, Vellas B. Frailty: an emerging Public Health Priority. J Am Med Dir Assoc. 2016;17(3):188–92. doi: 10.1016/j.jamda.2015.12.016. - DOI - PubMed
    1. Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci. 2004;59(3):255–63. doi: 10.1093/gerona/59.3.M255. - DOI - PubMed

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