Sonographic Assessment of Sarcopenia in Patients with Advanced Hip Osteoarthritis Before and After Joint Reconstruction Surgery

Osteoarthritis, or age-related degenerative joint disease, is a leading cause of disability and economic cost throughout the world. With an increasingly elderly and overweight population, rates of osteoarthritis are skyrocketing [1]. Advanced osteoarthritis of the hip is commonly treated surgically with hip arthroplasty, with the goal of achieving pain relief, improved hip function, increased activity level, and ultimately a higher quality of life [2]. Hip arthroplasty is one of the most common orthopedic procedures performed in the US with expected future increase in numbers. While largely a successful procedure, all hip replacements ultimately fail given sufficient time. Hip replacements are susceptible to a number of complications including infection, fracture, dislocation, neurovascular injury, and particle disease including the widely publicized high profile failure of some previously commonly used metal-on-metal prostheses [2-3]. The surgical decision-making process for hip arthroplasty is a crucial component of patient care and is substantially influenced by patient factors. Sarcopenia, or muscle wasting out of proportion to normal aging, is a common comorbidity seen in the elderly population and is a contributing factor to increasing morbidity, mortality and heath care costs after a variety of surgical procedures [4-6]. Prior studies have shown high prevalence of sarcopenia in orthopedic patients [7-8]. Thus, there is a great need for further research exploring the role of sarcopenia as a predictor of surgical outcomes in orthopedic patients [5]. Identification of sarcopenia is limited, however, due to lack of diagnostic criteria as well as limitations to currently employed diagnostic techniques. Novel ultrasound evaluation of muscle using cutting edge technology and algorithms shows promise as a new tool for sarcopenia diagnosis. To date, these ultrasound techniques have not been studied in the orthopedic hip arthroplasty population. Our study prop