METHODS: Electronic databases PubMed, Scopus, Cochrane, and Google Scholar were searched. The data were pooled using the random-effects model and graphically represented by a forest plot. We included a total of 13 studies, evaluating 399,097 patients.
RESULTS: The pooled prevalence of sarcopenia was 20.1% (95% confidence interval [CI] 13.6 to 28.8%; P < .00001; I2 = 94.7%) in total knee arthroplasty (TKA) and 5.2% (95% CI 0.1 to 69.7%; P = .128; I2 = 99.6%) in total hip arthroplasty (THA). Meta-regression found no links between age, sex, body mass index, diabetes, obesity, arthroplasty type, and sarcopenia prevalence in TJA. Sarcopenia increased risk of blood transfusion (odds ratio [OR] 4.68 [95% CI 3.51 to 6.25]; P < .00001), pneumonia (OR 1.94 [95% CI 1.14 to 3.30]; P = .01), urinary tract infection (UTI) (OR 1.64 [95% CI 1.31 to 2.05]; P < .001), prosthetic fracture (OR 2.12 [95% CI 1.51 to 2.98]; P < .0001), prosthetic dislocation (OR 1.99 [95% CI 1.62 to 2.44]; P < .00001), and mechanical loosening (OR 1.78 [95% CI 1.43 to 2.22]; P < .00001) in TKA. Sarcopenic patients were at an increased risk of UTI (OR 1.79 [95% CI 1.32 to 2.43]; P = .0002) and prosthetic loosening (OR 1.97 [95% CI 1.10 to 3.53]; P = .02) post-THA.
CONCLUSIONS: Baseline sarcopenia was prevalent in patients undergoing TJA. It was associated with an increased risk of UTI and prosthetic loosening following TKA and THA. Increased risk of blood transfusion, pneumonia, prosthetic fractures, and mechanical loosening following TKA.
结果:在全膝关节置换术(TKA)中,肌肉减少症的合并患病率为20.1%(95%CI[置信区间]13.6至28.8%;P<0.00001;I2=94.7%),在全髋关节置换术(THA)中为5.2%(95%CI0.1至69.7%;P=0.128;I2=99.6%)。元回归发现年龄之间没有联系,性别,体重指数(BMI),糖尿病,肥胖,关节成形术类型,TJA中的肌少症患病率。肌肉减少症增加输血风险(OR[比值比]4.68[95%CI3.51至6.25];P<0.00001),肺炎(OR1.94[95%CI1.14至3.30];P=0.01),尿路感染UTI(OR1.64[95%CI1.31to2.05];P<0.001),假体骨折(OR2.12[95%CI1.51至2.98];P<0.0001),假体脱位(OR1.99[95%CI1.62至2.44];P<0.00001),TKA中机械松动(OR1.78[95%CI1.43至2.22];P<0.00001)。肌肉减少患者在THA后UTI(OR1.79[95%CI1.32至2.43];P=0.0002)和假体松动(OR1.97[95%CI1.10至3.53];P=0.02)的风险增加。
结论:基线少肌症在接受TJA的患者中普遍存在。它与TKA和THA后UTI和假体松动的风险增加有关。输血风险增加,肺炎,假体骨折,TKA后机械松动。