The impact of sarcopenic obesity on knee and hip osteoarthritis: a scoping review

Kristine Godziuk, Carla M Prado, Linda J Woodhouse, Mary Forhan, Kristine Godziuk, Carla M Prado, Linda J Woodhouse, Mary Forhan

Abstract

Background: The progressive, debilitating nature of knee and hip osteoarthritis can result in severe, persistent pain and disability, potentially leading to a need for total joint arthroplasty (TJA) in end-stage osteoarthritis. TJA in adults with obesity is associated with increased surgical risk and prolonged recovery, yet classifying obesity only using body mass index (BMI) precludes distinction of obesity phenotypes and their impact on surgical risk and recovery. The sarcopenic obesity phenotype, characterized by high adiposity and low skeletal muscle mass, is associated with higher infection rates, poorer function, and slower recovery after surgery in other clinical populations, but not thoroughly investigated in osteoarthritis. The rising prevalence and impact of this phenotype demands further attention in osteoarthritis treatment models of care, particularly as osteoarthritis-related pain, disability, and current treatment practices may inadvertently be influencing its development.

Methods: A scoping review was used to examine the extent of evidence of sarcopenic obesity in adults with hip or knee osteoarthritis. Medline, CINAHL, Web of Science and EMBASE were systematically searched from inception to December 2017 with keywords and subject headings related to obesity, sarcopenia and osteoarthritis.

Results: Eleven studies met inclusion criteria, with indications that muscle weakness, low skeletal muscle mass or sarcopenia are present alongside obesity in this population, potentially impacting therapeutic outcomes, and TJA surgical risk and recovery.

Conclusions: Consideration of sarcopenic obesity should be included in osteoarthritis patient assessments.

Keywords: Arthroplasty; BMI; Body composition; Osteoarthritis; Sarcopenic obesity.

Conflict of interest statement

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Not applicable.

Competing interests

All authors declare they have no competing interests that would create a conflict of interest in connection with this manuscript. KG, CMP and MF have no disclosures; LJW has received funding from the Research Advisory Board of Focus on Therapeutic Outcomes Inc. (FOTO) and the American Physical Therapy Association Outcome Measures Registry.

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Figures

Fig. 1
Fig. 1
Relationship between aging, obesity and osteoarthritis and the development of sarcopenic obesity
Fig. 2
Fig. 2
Systematic search strategy and results

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