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中华关节外科杂志(电子版) ›› 2024, Vol. 18 ›› Issue (06) : 765 -772. doi: 10.3877/ cma.j.issn.1674-134X.2024.06.010

综述

全关节置换患者肌少症研究的范围综述
郭亚彬1,2, 周阳1,2, 刘晓彤1, 周杨1, 汪博雅1, 曾必云2,3,()   
  1. 1.410013 长沙中南大学湘雅护理学院
    2.410008 长沙中南大学湘雅医院临床护理教研室
    3.410008 长沙中南大学湘雅医院骨科
  • 收稿日期:2024-09-15 出版日期:2024-12-01
  • 通信作者: 曾必云
  • 基金资助:
    湖南省社会科学基金(23ZDB002)湖南省护理学会科研课题资助(HNKY202202)湖南省自然科学基金(2022JJ40766)

Scoping review of studies on sarcopenia in total joint replacement patients

Yabin Guo1,2, Yang Zhou1,2, Xiaotong Liu1, Yang Zhou1, Boya Wang1, Biyun Zeng2,3,()   

  1. 1.Xiang Ya Nursing School, Central South University,Changsha 410013, China
    2.Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha 410008, China
    3.Department of Orthopedics, Central South University Hospital,Changsha 410008, China
  • Received:2024-09-15 Published:2024-12-01
  • Corresponding author: Biyun Zeng
引用本文:

郭亚彬, 周阳, 刘晓彤, 周杨, 汪博雅, 曾必云. 全关节置换患者肌少症研究的范围综述[J/OL]. 中华关节外科杂志(电子版), 2024, 18(06): 765-772.

Yabin Guo, Yang Zhou, Xiaotong Liu, Yang Zhou, Boya Wang, Biyun Zeng. Scoping review of studies on sarcopenia in total joint replacement patients[J/OL]. Chinese Journal of Joint Surgery(Electronic Edition), 2024, 18(06): 765-772.

关节与肌肉是维持人体正常运动功能必不可少的两部分,肌少症会导致关节置换术后康复效果降低。本研究对全关节置换患者肌少症的相关研究进行范围审查,以范围综述方法学为指导,计算机检索中国知网、万方数据库、中国生物医学文献数据库、Web of Science、PubMed、护理学全文数据库(CINAHL)、Cochrane Library数据库,检索时限为建库至2024年4月1日,由两名研究生筛选文献、汇总和系统分析。最终纳入19篇文献。全关节置换患者术前肌少症发生率为1.3%~35.5%,主要应用SARC-F和小腿围进行筛查。患者肌少症的影响因素包括社会人口学、躯体状态、生物标志物、合并症等因素。干预方法包括运动干预、营养补剂干预、中医干预与多学科综合干预等。全关节置换患者术前肌少症发生率不等,受多种因素影响,未来还需要验证肌少症预测模型的稳定性,加强在全关节置换患者中的本土化筛查工具研究,及时识别全关节置换患者术前肌少症。

Joint and muscle function are essential for normal human movement, and sarcopenia can compromise post-joint replacement rehabilitation. This study conducted a scoping review of sarcopenia in patients undergoing total joint arthroplasty. Guided by scoping review methodology, the following data bases were searched:the China National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Literature Database, Web of Science, PubMed, Cumulative Index to Nursing and Allied Health Literature(CINAHL),and Cochrane Library from inception to April first, 2024. Two graduate students screened, summarized, and systematically analyzed the literature, ultimately including 19 studies. The prevalence of sarcopenia in preoperative total joint arthroplasty patients ranged from 1.3% to 35.5%, primarily assessed using SARC-F and calf circumference. Influencing factors included sociodemographic, physical status, biomarkers, and comorbidities. Interventions involved exercise, nutritional supplements, traditional Chinese medicine, and multidisciplinary approaches. The varying prevalence and influence of multiple factors highlight the need for further validation of sarcopenia prediction models and the development of culturally appropriate screening tools for timely identification of sarcopenia in total joint arthroplasty patients.

图1 文献筛选流程图
Figure 1 Flowchart of Literature Screening
表1 纳入文献的基本特征
纳入文献 发表时间 国家 研究类型 诊断 样本量(实验组/对照组,例) 发生率/干预时长
Godziuk等[7] 2019 加拿大 横断面研究 TKA 151 ASM/身高2:1.3%;ASM/体重2:14.6%;ASM/BMI:27.2%;EWGSOP:8.6%
Ha等[8] 2020 韩国 回顾性队列 髋部骨折 115 63.5%a
Liao等[9] 2021 中国 回顾性队列 TKA 587 10.1%
Ardelian等[10] 2022 美国 回顾性队列 TKA 90438 16.7%
Yu等[11] 2022 中国 前瞻性队列 THA术前 212 22.8%A;19.5%B
Borges等[12] 2022 西班牙 横断面研究 髋部骨折 90 30%
Hwang等[13] 2022 韩国 回顾性单中心研究 TKA 403 8.40%
Park等[14] 2022 韩国 回顾性队列研究 TKA 138 35.5%
Tzartza等[15] 2023 希腊 横断面研究 TKA 20 25%
Humphrey等[16] 2023 美国 多中心回顾性病例对照研究 TKA 140 22.90%
Nanri等[17] 2023 日本 回顾性队列 髋部骨折 599 29.2%b 32.2%c
郎俊哲等[18] 2018 中国 回顾性队列 THA 181 /
Liao等[19] 2021 中国 回顾性队列 TKA 190 /
Muyskens等[20] 2019 美国 随机对照试验 TKA 41 术前7 d持续至6周
Ikeda等[21] 2019 日本 随机对照试验 THA 31 1个月
Liao等[4] 2020 中国 随机对照试验 TKA 40 3个月
Han等[2] 2022 中国 前瞻性研究 THA 177 12个月
杨礼跃等[22] 2022 中国 随机对照试验 TJA 100 3个月
王培霞等[23] 2022 中国 随机对照试验 THA 114 6个月
纳入文献 测评指标 研究主题
Godziuk等[7] ①②④ 探索终末期膝关节骨关节炎成人中肌少性肥胖的患病率
Ha等[8] ①④ 评估老年髋部骨折患者的SARC-F问卷是否是肌肉减少症的有效筛查工具
Liao等[9] ①③⑥⑦ 探索老年膝关节骨关节炎患者全膝关节置换术后肌肉减少性肥胖及其混杂因素对膝关节活动范围的影响
Ardelian等[10] 探索是否合并肌少症的初次全膝关节置换患者术后疗效的对比
Yu等[11] 探索基于血清生物标志物的老年髋部骨折患者肌肉减少症的联合诊断方法
Borges等[12] ①②⑦ 探索小腿围作为预测髋部骨折住院老年人肌少症工具的价值
Hwang等[13] ①⑧ 探索基于深度学习的全腿X线平片的肌肉分割和定量模型预测TKA患者肌少症的潜力
Park等[14] ①⑧ 探索等待初次全膝关节置换术的亚洲女性患者中肌少症的患病率
Tzartza等[15] ③⑤ 探讨肌少症与骨关节炎共存对全膝关节置换术后患者康复及疼痛等症状的影响
Humphrey等[16] ①③⑤⑦ 确定肌少症和其他身体成分是否与原发性TKA后关节功能和自我报告身体功能相关
Nanri等[17] ①⑦ 探索老年全关节置换术患者肌少症风险对术后行走独立性的影响
郎俊哲等[18] ③⑦ 探讨肌少症与股骨颈骨折行髋关节置换术后早期功能的关系。
Liao等[19] ②③ 探索肌少症对老年膝关节骨关节炎患者全膝关节置换术后康复效果的影响
Muyskens等[20] 探索全膝关节置换术前后补充必需氨基酸对细胞和形态学的影响
Ikeda等[21] ①④ 探索运动疗法联合补充支链氨基酸对老年妇女全髋关节置换术后肌力的影响
Liao等[4] ①②③⑦ 确定TKR后弹性阻力运动对超重和肥胖老年KOA女性肌肉质量和功能结局的影响
Han等[2] ①③④⑤⑦ 探索阻力训练与β-羟基-β-甲基丁酸补充剂相结合对髋关节置换术后患有肌少症的老年患者的影响
杨礼跃等[22] ①③ 探讨八珍汤加减对老年人工关节置换合并骨骼肌减少症的治疗效果
王培霞等[23] ①③⑦ 探讨多学科联合康复在人工全髋关节置换术后伴肌少症患者中的应用效果
图2 年发文量
Figure 2 Annual number of publications
图3 不同国家发文数量
Figure 3 The number of published articles in different countries
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