Effect of Total Knee Arthroplasty on Sarcopenia in Patients With Osteoarthritis in the Knee

Osteoarthritis, Knee Clinical Trial

— Sarcopenia  

Official title:

Effect of Total Knee Arthroplasty on Sarcopenia in Patients With Osteoarthritis in the Knee

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03579329
• Other study ID #: 2015.539
• Status: Completed
• Start date: April 30, 2020
• Est. completion date: February 2, 2022

Study information

• Verified date: March 2022
• Source: Chinese University of Hong Kong
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

Sarcopenia is a wasting disease with the locomotion system in the aged population. It is defined as the decline in muscle mass (lean body mass) and strength with the advance of age. The prevalence of sarcopenia increases with age, reaching an astounding 50% among the population aged over 75 in the United States. Sarcopenia is often associated with frailty, falls, and disability. Studies have found sarcopenia can be a predicting risk factor for fractures in the elderly. In addition, sarcopenia predicted a higher chance of mortality in nursing homes.

Description:

Notably, sarcopenia often accompanies with osteoarthritis (OA). However, the relationship between sarcopenia and OA is still unclear. One understanding is that sarcopenia and OA and co-existing conditions. One study identified sarcopenia as one of the risk factors of OA. There is also a study which speculated that OA may inhibit the progression of sarcopenia since they observed OA patients had higher BMP4-positive tissues, which indicated presence of satellites cells that may increase muscle regeneration capabilities.

However, more studies suggested that OA may contribute to the development of sarcopenia among the elderly. First, it is observed that the prevalence of sarcopenia among OA patients is higher than among the normal population. Further, cross-sectional studies demonstrated that hip or knee OA are associated with declines in muscle mass and muscle strength. Most interestingly, female patients with knee OA had declined lean body mass in their lower limbs, but not in their upper limbs or trunks.

Major risk factors of sarcopenia include malnutrition and lack of physical exercise. Therefore, diet supplementation and exercise potentially provide means to alleviate sarcopenia. Studies have demonstrated that strength training in the elderly can improve sarcopenia by increasing muscle strength, mass, power and quality. Exercise habit in middle age could prevent sarcopenia in elder age, maintaining better scores in grip strength, gait speed, and one-leg standing time. Possible molecular mechanism of exercise on sarcopenia is the upregulated nuclear factor-erythroid 2 p45-related factor 2 (Nrf2)-mediated antioxidant response cascade in skeletal muscle, which protected the muscle from oxygen species-mediated toxicity.

OA patients often adopt a sedentary life style to avoid joint pain and stiffness, which probably triggers the dysfunction of Nrf2 -mediated antioxidant response cascade, eventually leading to skeletal muscle atrophy. With the ultimate solution, total knee anthroplasty (TKA), patients with knee OA gradually regain their mobility and greatly increase their social and physical activities. Therefore, one can expect to see improved sarcopenia in patients with knee OA after TKA.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 58
• Est. completion date: February 2, 2022
• Est. primary completion date: February 2, 2022
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Male and Female aged over 18 wirh end stage knee OA

• Scheduled for TKA

• Agree to provide written consent

Exclusion Criteria:

• History of alcoholism or drug abuse

• Pregnancy and breast-feeding

• Presence of serious pathologies

• Steroid-based systemic therapy in progress or interrupted since less than 1 month

• With significant hematologic diseases

Related Conditions & MeSH terms

• Osteoarthritis
• Osteoarthritis, Knee
• Sarcopenia

Intervention

Procedure:
• Total Knee Arthroplasty
Effect of Total Knee Arthroplasty on Sarcopenia in Patients with Osteoarthritis in the Knee

Locations

Country	Name	City	State
Hong Kong	Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong	Hong Kong

Sponsors (1)

Lead Sponsor	Collaborator
Chinese University of Hong Kong

Country where clinical trial is conducted

Hong Kong, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	International Physical Activity Questionnaire (IPAQ)	Questionnaire	one year
Primary	DXA scan	Lean Muscle Mass Index	one year
Secondary	Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)	Questionnaire	one year
Secondary	Self-Rated 12	Questionnaire	one year