The Journal of Arthroplasty · Dec 13, 2025
Recognizing Sarcopenia in Total Knee Arthroplasty Patients: A Call for Greater Awareness
By Taşcı M, Özer M, Çamur S
BACKGROUND: Suspected sarcopenia, marked by early muscle weakness and functional decline, is increasingly recognized in elderly patients and may negatively affect total knee arthroplasty (TKA) outcomes. Although formal diagnosis may not always be practical, early identification through simple screening tools such as the Strength, Assistance with walking, Rising from a chair, Climbing stairs, and Falls (SARC-F) questionnaire and basic functional tests can help detect at-risk patients and improve postoperative management and prognosis. METHODS: This retrospective study included 97 patients who underwent unilateral TKA. Sarcopenia was assessed using the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) algorithm. All patients completed the SARC-F and Sarcopenia Quality‑of‑Life (SarQoL), Oxford, and Knee Society Score (KSS), as well as pre- and postoperative Visual Analog Scale (VAS) scores. RESULTS: Suspected sarcopenia was present in 34 patients (35.1%), while 63 patients (64.9%) had no suspicion. Probable sarcopenia based on handgrip strength was identified in eight patients, whereas no patient met the muscle mass cutoff for confirmed sarcopenia. Patients who had suspected sarcopenia were older (P= 0.05), had higher postoperative VAS scores (P = 0.05), and more frequently fell below handgrip cutoff values (P = 0.03). Gait speed was significantly slower in this group (P < 0.01). They also demonstrated lower Oxford scores (P < 0.01) and a trend toward lower KSS scores (P = 0.07). Postoperative walking aid requirement (P = 0.03) and comorbidity rates (P = 0.04) were significantly higher in patients who had suspected sarcopenia. CONCLUSIONS: Patients who had suspected sarcopenia exhibited poorer functional outcomes following TKA, even in the absence of reduced muscle mass on bioimpedance analysis. The SARC-F questionnaire, as a simple and practical tool, may provide early recognition of patients at risk and guide interventions to improve postoperative satisfaction and recovery.