Page 150 - Ebook-Book JCMS 2025

High Prevalence of Osteoporosis and Sarcopenia in Patients
Undergoing Knee Arthroplasty
Korawish Mekariya, Pongpak Bhumiwat, Ekasame Vanitcharoenkul, Pojchong Chotiyarnwong,
Aasis Unnanuntana*
Department of Orthopaedic Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University
*Corresponding Author E-mail: uaasis@gmail.com
Background: Abstract
With the global shift toward an aging population, age-related conditions such as
osteoporosis, sarcopenia, and osteoarthritis are becoming increasingly prevalent. In
patients undergoing knee arthroplasty (KA), osteoporosis has been shown to increase
the risk of periprosthetic fractures, while sarcopenia is associated with a higher incidence
of postoperative medical complications. Despite their clinical importance, data on the
prevalence of these conditions in KA patients remain limited. We aimed to determine the
prevalence of osteoporosis, sarcopenia, and osteosarcopneia in patients undergoing KA.
Methods: This cross-sectional study enrolled patients who underwent elective KA at a single tertiary
care hospital. Risk factors and previous treatment for osteoporosis were collected. All
patients were evaluated for 25-hydroxyvitamin D level, bone mineral density, skeletal
muscle mass, grip strength, and the 5-time Chair Stand test. Osteoporosis and sarcopenia
were diagnosed according to the World Health Organization definition and the Asian
Working Group for Sarcopenia 2019 criteria, respectively.
Results: A total of 205 patients were included (mean age 70.2 ± 7.9 years; 86.3% female). The
prevalence of osteoporosis, sarcopenia, and osteosarcopenia was 53.7%, 23.9%, and 16.1%,
respectively. Notably, only 22.7% of patients who met the indication for anti-osteoporosis
treatment had received pharmacologic therapy before surgery, and less than half of KA
patients (41.5%) had received calcium and vitamin D supplementation. Additionally,
one-third of patients (36.6%) were found to have vitamin D deficiency (<20ng/ml).
Conclusions: Osteoporosis and sarcopenia are highly prevalent among patients with advanced knee
osteoarthritis undergoing KA, with 16% diagnosed with osteosarcopenia. Despite this
substantial burden, the treatment rate remains surprisingly low; less than one-quarter
of patients indicated for therapy received anti-osteoporotic medication. Comprehensive
assessment and preoperative optimization for osteoporosis and sarcopenia should be
prioritized to improve surgical outcomes and long-term musculoskeletal health in this
aging population.
148 Joint Conference in Medical Sciences 2025