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AB0368 PHYSICAL FRAILTY WAS NOT APPROPRIATE MEASURE FOR ASSESSING PHYSICAL FUNCTION IN PATIENTS WITH KNEE JOINT DISORDER AMONG THREE DIFFERENT METHODS
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AB0368 PHYSICAL FRAILTY WAS NOT APPROPRIATE MEASURE FOR ASSESSING PHYSICAL FUNCTION IN PATIENTS WITH KNEE JOINT DISORDER AMONG THREE DIFFERENT METHODS
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Journal Article
AB0368 PHYSICAL FRAILTY WAS NOT APPROPRIATE MEASURE FOR ASSESSING PHYSICAL FUNCTION IN PATIENTS WITH KNEE JOINT DISORDER AMONG THREE DIFFERENT METHODS
2024
Overview
Background:Knee joint dysfunction remarkably decreases mobility of the elderly, reconstruction of knee joint function is important to maintain their healthy and independent life. And nowadays, the number of total knee arthroplasty (TKA) is increasing worldwide for that purpose. Successful results of the surgery seem to depend on several preoperative factors including age, muscle strength of lower limbs, frail status, range of motion of the knees.Objectives:We assessed physical function by 3 different methods physical frailty, sarcopenia, and locomotive syndrome in patients with knee disorder just before arthroplasty and investigated the relationship between impairment of mobility and preoperative factors.Methods:All patients scheduled to undergo TKA at our hospital from July 2020 to September 2022 were assessed for basic attributes, clinical assessment, radiography, whole-body mode DXA, knee muscle strength with written informed consent. And frailty by Japanese Cardiovascular Health Study criteria, sarcopenia by Asian Working Group for Sarcopenia 2019 criteria, and locomotive syndrome (LS) by Japanese Orthopedic Association were evaluated.Results:Characteristics of the patients included in this study were shown in Table 1. Among 204 patients (213 knees),172 women, mean age 75.0 years, the overall distribution in frailty was no: 14.6%, pre-frailty: 58.5%, and frailty: 26.8%. That in sarcopenia was no: 93.3%, yes: 3.7%, and severe: 3.7% and in LS Stage 0: 0%, Stage 1: 3.3%, Stage 2: 11.4%, and stage 3: 85.3%. The most prevalent group comprised patients with LS stage 3 without sarcopenia but classified as pre-frail (n=94). The next most common group included patients with LS stage 3 without sarcopenia but classified as frailty (n=43). Eighty-seven percent of the patients with frailty and 92% with LS stage 3 did not suffer from sarcopenia (Table 2). Statistically significant relationships were observed between sarcopenia and frailty (p=0.003; Fisher’s exact test), while no relationship between LS and frailty (p=0.442; Fisher’s exact test) or LS and sarcopenia (p=0.889; Fisher’s exact test). Multivariate analysis of related factors with severity level for frailty and locomotive syndrome revealed correlations for frailty with gait speed (p=0.02) and sarcopenia (p=0.04), whereas statistically significant correlation for LS with KSS (p=0.00) and muscle strength (p=0.01).Conclusion:In the patients with end stage knee OA immediately before arthroplasty, there were a small number of patients with coexisting sarcopenia in physical frailty or LS Stage 3. Therefore, the skeletal muscles of such patients did not deteriorate, although their morbidity was impaired. Locomotive syndrome status was considered appropriate for the assessment of mobility function in such patients rather than physical frailty.Table 1.Characteristics of the patients who were scheduled to undergo knee arthroplastyFactorsn=204 (213 knees)Female (n, (%))172 (80.8%)age (mean, (SD))75 years old(7.7)body mass index (kg/m2) (mean, (SD))26.3 kg/m2 (4.6)symptomatic period (median [min-max])5.0 years [0-38]smoking: never, ever, current (n (%))144 (74.2%), 33 (17.0%), 17 (8.8%)Knee Society Score (mean, (SD))76.2 (27.6)JOA Score (mean, (SD))50.7 (6.7)Pain VAS (mean, (SD))43.2 (29.8)Femoro-Tibial angle on X-ray (mean, (SD))182.2 (8.6)ROM (degree)Extension (mean, (SD))-10.2 (6.8)Flexion (mean, (SD))118.6 (13.6)Muscle strength (N)5.0 years [0-38]Extension (mean, (SD))142.3 (59.0)Flexion (mean, (SD))94.7 (42.6)Grip power (kg) (mean, (SD))19.5 (6.4)Gait speed (m/sec) (mean, (SD))0.90 (0.32)ASMI (kg/m2) (mean, (SD))6.83 (1.10)JOA: Japanese Orthopedic Association, VAS: Visual Analogue Scale, ROM: range of motion, ASMI: appendicular skeletal muscle mass index,Table 2.Frequency of complications of the three diseasesFrailty StatusNon-Frailty(29, 14.6%)PreFrailty(118, 58.5%)Frailty(55, 26.8%)Locomotive Syndrome stageStage 0(0, 0 %)non-Sarcopenia000Sarcopenia000Stage 1(7, 3.3%)non-Sarcopenia061Sarcopenia000Stage-2(22, 11.4%)non-Sarcopenia5124Sarcopenia010Stage 3(173, 85.3%)non-Sarcopenia239443Sarcopenia157REFERENCES:NIL.Acknowledgements:NIL.Disclosure of Interests:None declared.
Publisher
BMJ Publishing Group Ltd and European League Against Rheumatism,Elsevier B.V,Elsevier Limited
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