{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:44:48Z","timestamp":1790804688728,"version":"4.1.0"},"reference-count":53,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,2,13]],"date-time":"2023-02-13T00:00:00Z","timestamp":1676246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biology"],"abstract":"<jats:p>Sarcopenia is a state of catabolic muscle wasting prevalent in geriatric patients. Likewise, osteoarthritis is an age-related musculoskeletal disease affecting patients with similar demographics. Late-stage hip osteoarthritis is often treated with total hip arthroplasty (THA). As sarcopenia influences the surgical outcomes, this study aimed to assess the impact of sarcopenia on the outcomes of THA. A 1:3 matched case\u2013control study of sarcopenic to control patients was performed using a large national database. In total, 3992 patients were analyzed. Sarcopenic patients undergoing THA were more likely to experience dislocation (odds ratio (OR) = 2.19, 95% confidence interval (CI) 1.21\u20133.91) within 1 year of THA. Furthermore, sarcopenic patients had higher urinary tract infection rates (OR = 1.79, CI 1.32\u20132.42) and a greater risk of 90-day hospital readmission (hazard ratio (HR) = 1.39, CI 1.10\u20131.77). Sarcopenic patients experienced more falls (OR = 1.62, CI 1.10\u20132.39) and fragility fractures (OR = 1.77, CI 1.34\u20132.31). Similarly, sarcopenic patients had higher day of surgery costs (USD 13,534 vs. USD 10,504) and 90-day costs (USD 17,139 vs. USD 13,394) compared with the controls. Ultimately, sarcopenic patients undergoing THA experience higher rates of postoperative complications and incur greater medical costs. Given the potential risks, orthopedic surgeons may consider treating or reducing the severity of sarcopenia before surgery.<\/jats:p>","DOI":"10.3390\/biology12020295","type":"journal-article","created":{"date-parts":[[2023,2,13]],"date-time":"2023-02-13T04:07:19Z","timestamp":1676261239000},"page":"295","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Sarcopenia Is Associated with an Increased Risk of Postoperative Complications Following Total Hip Arthroplasty for Osteoarthritis"],"prefix":"10.3390","volume":"12","author":[{"given":"Kenny","family":"Chang","sequence":"first","affiliation":[{"name":"Warren Alpert Medical School of Brown University, Providence, RI 02903, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9579-9924","authenticated-orcid":false,"given":"J. Alex","family":"Albright","sequence":"additional","affiliation":[{"name":"Warren Alpert Medical School of Brown University, Providence, RI 02903, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward J.","family":"Testa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alanna B.","family":"Balboni","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan H.","family":"Daniels","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Papadopoulou, S.K. (2020). Sarcopenia: A Contemporary Health Problem among Older Adult Populations. Nutrients, 12.","DOI":"10.3390\/nu12051293"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1002\/jcsm.12147","article-title":"Welcome to the ICD-10 code for sarcopenia","volume":"7","author":"Anker","year":"2016","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/ageing\/afy169","article-title":"Sarcopenia: Revised European consensus on definition and diagnosis","volume":"48","author":"Bahat","year":"2019","journal-title":"Age Ageing"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Sobestiansky, S., Michaelsson, K., and Cederholm, T. (2019). Sarcopenia prevalence and associations with mortality and hospitalisation by various sarcopenia definitions in 85\u201389\u2009year old community-dwelling men: A report from the ULSAM study. BMC Geriatr., 19.","DOI":"10.1186\/s12877-019-1338-1"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.cger.2016.08.002","article-title":"Pathogenesis and Management of Sarcopenia","volume":"33","author":"Dhillon","year":"2017","journal-title":"Clin. Geriatr. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1016\/j.jtcvs.2018.06.098","article-title":"The impact of preoperative sarcopenia, defined based on psoas muscle area, on long-term outcomes of heart valve surgery","volume":"157","author":"Okamura","year":"2019","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Pipek, L.Z., Baptista, C.G., Nascimento, R.F.V., Taba, J.V., Suzuki, M.O., do Nascimento, F.S., Martines, D.R., Nii, F., Iuamoto, L.R., and Carneiro-D\u2019Albuquerque, L.A. (2020). The impact of properly diagnosed sarcopenia on postoperative outcomes after gastrointestinal surgery: A systematic review and meta-analysis. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0237740"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1001\/jamaoto.2020.1154","article-title":"Association of Sarcopenia With Oncologic Outcomes of Primary Surgery or Definitive Radiotherapy Among Patients with Localized Oropharyngeal Squamous Cell Carcinoma","volume":"146","author":"Olson","year":"2020","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/j.joca.2022.03.001","article-title":"Estimating incidence and prevalence of hip osteoarthritis using electronic health records: A population-based cohort study","volume":"30","author":"Arslan","year":"2022","journal-title":"Osteoarthr. Cartil."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1302\/2058-5241.3.170068","article-title":"Total hip arthroplasty: Survival and modes of failure","volume":"3","author":"Karachalios","year":"2018","journal-title":"EFORT Open Rev."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"780","DOI":"10.2106\/00004623-200704000-00012","article-title":"Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030","volume":"89","author":"Kurtz","year":"2007","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_12","first-page":"884","article-title":"Dislocation following total hip replacement","volume":"111","author":"Dargel","year":"2014","journal-title":"Dtsch. Arztebl. Int."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2353","DOI":"10.1016\/j.arth.2021.01.022","article-title":"Mortality After Revision Total Hip Arthroplasty","volume":"36","author":"Laughlin","year":"2021","journal-title":"J. Arthroplast."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"311","DOI":"10.5301\/hipint.5000416","article-title":"Quality of life after staged revision for infected total hip arthroplasty: A systematic review","volume":"26","author":"Rietbergen","year":"2016","journal-title":"Hip Int."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1097\/01.blo.0000214439.95268.59","article-title":"Economic burden of revision hip and knee arthroplasty in Medicare enrollees","volume":"446","author":"Ong","year":"2006","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Wang, H., Wang, N., Wang, Y., and Li, H. (2022). Association between sarcopenia and osteoarthritis: A protocol for meta-analysis. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0272284"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.arth.2018.09.037","article-title":"Sarcopenia as a Risk Factor for Prosthetic Infection After Total Hip or Knee Arthroplasty","volume":"34","author":"Babu","year":"2019","journal-title":"J. Arthroplast."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1055\/s-0040-1713355","article-title":"Comparative Analysis on the Effects of Sarcopenia following Primary Total Knee Arthroplasty: A Retrospective Matched-Control Analysis","volume":"35","author":"Ardeljan","year":"2022","journal-title":"J. Knee Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e131","DOI":"10.1016\/j.wneu.2022.10.077","article-title":"Sarcopenia and Postoperative Complications, Cost of Care, and All-Cause Hospital Readmission Following Lumbar Spine Arthrodesis: A Propensity Matched Cohort Study","volume":"169","author":"Albright","year":"2022","journal-title":"World Neurosurg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1080\/14397595.2021.1899603","article-title":"The prevalence and impact of sarcopenia in females undergoing total hip arthroplasty: A prospective study","volume":"32","author":"Ueoka","year":"2022","journal-title":"Mod. Rheumatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1589\/jpts.34.60","article-title":"Differences in preoperative function and outcome of patients with versus without sarcopenia after total hip arthroplasty","volume":"34","author":"Koto","year":"2022","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1016\/j.jamda.2022.01.056","article-title":"Impact of Sarcopenia and Obesity on Gait Speed After Total Knee Replacement","volume":"23","author":"Liao","year":"2022","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e1159","DOI":"10.3928\/01477447-20160811-02","article-title":"Effect of Sarcopenia on Postoperative Morbidity and Mortality After Thoracolumbar Spine Surgery","volume":"39","author":"Bokshan","year":"2016","journal-title":"Orthopedics"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1007\/s00068-013-0313-3","article-title":"Psoas:lumbar vertebra index: Central sarcopenia independently predicts morbidity in elderly trauma patients","volume":"40","author":"Ebbeling","year":"2014","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Sim, J.H., Lee, S.H., Kim, J.W., Koh, W.U., Kim, H.T., Ro, Y.J., and Kim, H.J. (2021). Low Psoas Lumbar Vertebral Index Is Associated with Mortality after Hip Fracture Surgery in Elderly Patients: A Retrospective Analysis. J. Pers. Med., 11.","DOI":"10.3390\/jpm11070673"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"314","DOI":"10.5435\/00124635-200409000-00006","article-title":"Dislocation after total hip arthroplasty","volume":"12","author":"Soong","year":"2004","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"122","DOI":"10.5312\/wjo.v3.i8.122","article-title":"Instability after total hip arthroplasty","volume":"3","author":"Werner","year":"2012","journal-title":"World J. Orthop."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2059","DOI":"10.1007\/s00264-018-3908-9","article-title":"Soft tissue tension is four times lower in the unstable primary total hip arthroplasty","volume":"42","author":"Ogawa","year":"2018","journal-title":"Int. Orthop."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1548","DOI":"10.2106\/JBJS.15.01073","article-title":"Postoperative Limb-Offset Discrepancy Notably Affects Soft-Tissue Tension in Total Hip Arthroplasty","volume":"98","author":"Takao","year":"2016","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1007\/s00264-016-3216-1","article-title":"Soft tissue restricts impingement-free mobility in total hip arthroplasty","volume":"41","author":"Woerner","year":"2017","journal-title":"Int. Orthop."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Inacio, M., Ryan, A.S., Bair, W.N., Prettyman, M., Beamer, B.A., and Rogers, M.W. (2014). Gluteal muscle composition differentiates fallers from non-fallers in community dwelling older adults. BMC Geriatr., 14.","DOI":"10.1186\/1471-2318-14-37"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1007\/s00264-019-04468-x","article-title":"Could the tendon degeneration and the fatty infiltration of the gluteus medius affect clinical outcome in total hip arthroplasty?","volume":"44","author":"Vadala","year":"2020","journal-title":"Int. Orthop."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"290","DOI":"10.2106\/JBJS.D.02799","article-title":"Hospital cost of dislocation after primary total hip arthroplasty","volume":"88","author":"Haidukewych","year":"2006","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"29","DOI":"10.2340\/17453674.2022.2754","article-title":"Patient-reported outcome after dislocation of primary total hip arthroplasties: A cross-sectional study derived from the Danish Hip Arthroplasty Register","volume":"93","author":"Hermansen","year":"2022","journal-title":"Acta Orthop."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2640","DOI":"10.1016\/j.injury.2020.08.031","article-title":"Association between sarcopenia and fall characteristics in older adults with fragility hip fracture","volume":"51","author":"Lim","year":"2020","journal-title":"Injury"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1007\/s00198-018-04828-0","article-title":"The relationship between sarcopenia and fragility fracture-a systematic review","volume":"30","author":"Wong","year":"2019","journal-title":"Osteoporos. Int."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Brown, J.P., Adachi, J.D., Schemitsch, E., Tarride, J.E., Brown, V., Bell, A., Reiner, M., Oliveira, T., Motsepe-Ditshego, P., and Burke, N. (2021). Mortality in older adults following a fragility fracture: Real-world retrospective matched-cohort study in Ontario. BMC Musculoskelet. Disord., 22.","DOI":"10.1186\/s12891-021-03960-z"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Han, A., Bokshan, S.L., Marcaccio, S.E., DePasse, J.M., and Daniels, A.H. (2018). Diagnostic Criteria and Clinical Outcomes in Sarcopenia Research: A Literature Review. J. Clin. Med., 7.","DOI":"10.3390\/jcm7040070"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"S325","DOI":"10.1016\/j.arth.2020.01.039","article-title":"The Effect of Bladder Catheterization Technique on Postoperative Urinary Tract Infections After Primary Total Hip Arthroplasty","volume":"35","author":"Garbarino","year":"2020","journal-title":"J. Arthroplast."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"9","DOI":"10.22540\/JFSF-06-009","article-title":"Frailty associated urinary tract infections (FaUTIs)","volume":"6","author":"Kostakopoulos","year":"2021","journal-title":"J. Frailty Sarcopenia Falls"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1002\/nau.24001","article-title":"Investigation of the relationship between bladder function and sarcopenia using pressure flow studies in elderly male patients","volume":"38","author":"Majima","year":"2019","journal-title":"Neurourol. Urodyn."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/j.jjcc.2020.07.010","article-title":"Sarcopenia as a prognostic factor for outcomes after isolated tricuspid valve surgery","volume":"76","author":"Oh","year":"2020","journal-title":"J. Cardiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"7964","DOI":"10.1002\/cam4.3428","article-title":"Sarcopenia and adverse health-related outcomes: An umbrella review of meta-analyses of observational studies","volume":"9","author":"Xia","year":"2020","journal-title":"Cancer Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1111\/j.1532-5415.2004.52014.x","article-title":"The healthcare costs of sarcopenia in the United States","volume":"52","author":"Janssen","year":"2004","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"31","DOI":"10.2147\/CLEP.S122829","article-title":"Risk of pneumonia and urinary tract infection within the first week after total hip arthroplasty and the impact on survival","volume":"9","author":"Glassou","year":"2017","journal-title":"Clin. Epidemiol."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Liao, C.D., Wu, Y.T., Tsauo, J.Y., Chen, P.R., Tu, Y.K., Chen, H.C., and Liou, T.H. (2020). Effects of Protein Supplementation Combined with Exercise Training on Muscle Mass and Function in Older Adults with Lower-Extremity Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Trials. Nutrients, 12.","DOI":"10.3390\/nu12082422"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.jot.2020.04.002","article-title":"Sarcopenia: Current treatments and new regenerative therapeutic approaches","volume":"23","author":"Lo","year":"2020","journal-title":"J. Orthop. Translat."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"926","DOI":"10.14740\/jocmr2361w","article-title":"Nutrition for Sarcopenia","volume":"7","author":"Yanai","year":"2015","journal-title":"J. Clin. Med. Res."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"899","DOI":"10.3945\/ajcn.113.064154","article-title":"Protein-enriched diet, with the use of lean red meat, combined with progressive resistance training enhances lean tissue mass and muscle strength and reduces circulating IL-6 concentrations in elderly women: A cluster randomized controlled trial","volume":"99","author":"Daly","year":"2014","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1016\/j.clnu.2020.08.017","article-title":"Effects of adequate dietary protein with whey protein, leucine, and vitamin D supplementation on sarcopenia in older adults: An open-label, parallel-group study","volume":"40","author":"Lin","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2110","DOI":"10.1016\/j.arth.2021.02.002","article-title":"Crohn\u2019s Disease is Associated with Longer In-Hospital Lengths of Stay and Higher Rates of Complications and Costs after Primary Total Hip Arthroplasty","volume":"36","author":"Voyvodic","year":"2021","journal-title":"J. Arthroplast."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1016\/j.arth.2020.08.017","article-title":"Paget\u2019s Disease in Primary Total Hip Arthroplasty Is Associated With Greater In-Hospital Lengths of Stay, Costs, and Complications","volume":"36","author":"Hernandez","year":"2021","journal-title":"J. Arthroplast."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1080\/17453674.2018.1475179","article-title":"Risk of further surgery on the same or opposite side and mortality after primary total hip arthroplasty: A multi-state analysis of 133,654 patients from the Swedish Hip Arthroplasty Register","volume":"89","author":"Cnudde","year":"2018","journal-title":"Acta Orthop."}],"container-title":["Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-7737\/12\/2\/295\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:33:14Z","timestamp":1760121194000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-7737\/12\/2\/295"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,13]]},"references-count":53,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["biology12020295"],"URL":"https:\/\/doi.org\/10.3390\/biology12020295","relation":{},"ISSN":["2079-7737"],"issn-type":[{"value":"2079-7737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,13]]}}}