Prevalence of sarcopenia indicators and sub-optimal protein intake among elective total joint replacement patients.

Abstract

Sarcopenia is associated with falls, and can complicate recovery following total joint replacement (TJR) surgery. We examined (1) the prevalence of sarcopenia indicators and lower-than-recommended protein intake among TJR patients and non-TJR community participants and (2) the relationships between dietary protein intake and sarcopenia indicators. We recruited adults ≥65 years of age who were undergoing TJR, and adults from the community not undergoing TJR (controls). We assessed grip strength and appendicular lean soft-tissue mass (ALSTM_BMI) using DXA, and applied the original Foundation for the National Institutes of Health Sarcopenia Project cut-points for sarcopenia indicators (grip strength <26 kg for men and <16 kg for women; ALSTM <0.789 m² for men and <0.512 m² for women) and less conservative cut-points (grip strength <31.83 kg for men and <19.99 kg for women; ALSTM <0.725 m² for men and <0.591 m² for women). Total daily and per meal protein intakes were derived from 5-day diet records. Sixty-seven participants (30 TJR, 37 controls) were enrolled. Using less conservative cut-points for sarcopenia, more control participants were weak compared with TJR participants (46% versus 23%, p = 0.055), and more TJR participants had low ALSTM_BMI (40% versus 13%, p = 0.013). Approximately 70% of controls and 76% of TJR participants consumed <1.2 g protein/kg/day (p = 0.559). Total daily dietary protein intake was positively associated with grip strength (r = 0.44, p = 0.001) and ALSTM_BMI (r = 0.29, p = 0.03). Using less conservative cut-points, low ALSTM_BMI, but not weakness, was more common in TJR patients. Both groups may benefit from a dietary intervention to increase protein intake, which may improve surgical outcomes in TJR patients.