Introduction: KOA affects cartilage, periarticular and and synovial tissue. Obesity: Risk factor for genesis and KOA progression, and future

totak knee arthroplasty (TKA) muscle mass (lean mass) protects against KOA progression.

Differences between body composition parameters in early (EKOA) or advanced stages KOA not found in Medical literature

Implications of body composition in EKOA vs LKOA in PROs pre and post TKA is a subject required to be explored.

Methods:

Patients recruited from primary and tertiary hospital care. Inclusion criteria EKOA group:

KOA ACR Classification criteria, Men and women <55 y.o. Kellgren-Lawrence I or II.

Inclusion criteria LKOA group: KOA ACR Classification criteria, Men and women of any age,

Kellgren-Lawrence III-IV,fullfilling AAOS criteria for one or both knee total arthroplasty.

Exclusion criteria for both groups: Patients with any secondary cause for KOA. Patients with fibromyalgia or any previously autoimmune

diasease. Both groups received same baseline evaluations: Full clinimetry,

standarized protocol for multifrequency bioimpedance body composition assesment (InBody 720®); demographic, epidemiologic, quality of life, knee pain and functionality questionares.

Analysis. Bivariate analysis using appropriate to compare median between EKOA vs LKO patients.

Results: 110 patients evaluated (56 EKOA/54 LKOA) paired by gender.Proportion of women(71.8%) vs men (28.2%) was superior for female group.EKAO yonger than LKOA median 48.5 vs 65.5 y.o respectivelyComparisons between body composition and PROs shown on table

DIFFERENCE IN BODY COMPOSITION BETWEEN PATIENTS WITH EARLY KNEE OSTEOARTHRITIS (KOA), COMPARED TO LATE KNEE OA IN A MEXICAN POPULATION

VALERIO-MORALES IA1, SANCHEZ A, HERNÁNDEZ A, PABELTO P, EVIA A, ILIZALITURRI V, ESPINOSA R. INSTITUTO NACIONAL DE REHABILITACIÓN/UNIVERSIDAD NACIONAL AUTÓNOMA DE MÉXICO

Comparison EKOA vs LKOA body compositionVariable EKOA LKOA p value

BMI (kg/m2) WomenMen 29.8 (22.2-45.6)

28.3 (24.3-40.1) 30.4 (20.2-42.9)

29.3 (23.1-38) 0.430.58

Total lean mass (kg)Women

Men 35 (18-36)27.6 (19-38.5)

20.8 (13.4 – 26.6)27.9 (21.5 – 41.3)

0.0010.71

Lean mass index(kg/m2)

WomenMen  9.9 (8.1-12.8)

10.2 (8.4-13.3)

 8.8 (7.1-10.8)

10.1(8.5-12.6)

 0.0010.71

Total body fat (kg)* Women

Men

 28.4(14-60)

26(13-48)

 32.5(14.4-52.2)

27.1(13.8-45.3)

 0.14

0.71

Body fat index* (kg/m2) Women

Men

 11.2 (4.7-24.3)

10.2(5-17.8)

 14.2(6.2-23.4)

10.2(5.7-16.8)

 0.0050.71

Appendicular lean mass in

right symptomatic knee (kg)

Women

Men

  6.57 (4.84-9.81)

7.28(5.31-8.64)

  5.1(2.44-7.63)

7.65(6.08-10-76)

  0.0090.508

Appendicular lean mass in

left symptomatic knee (kg)

WomenMen

6.44(4.59-8.75)

7.39(6.95-10.41)

5.12(4.07-7.12)

7.45(5.77-8.33)

0.0080.819

WOMAC (Domains)Pain*

Stiffness*Physical^

Tota^

 7 (0-20)

2.7 (1.70)22.3(12.8)

31.6(16.8)

 9 (1-18)

3.1 (1.66)32.9(11.3)

44.9(15.01)

 0.008⌘

0.1471§

0.001§

0.001§

EuroQol* 0.493 (0.1748-0.7902) 0.5942 (0.1703-1) 0.018¶

Lequesne^ 13.8 (3.6) 8.6(3.59) 0.001§

*Median (Rank) , ^Mean (SD) ,§ T-Test ,¶ Mann-Whitney, Pearson-Chi⌘

Conclusions: Differences found only in female gender groups comparisons.LKOA group had less total lean mass, lean mass index and more total body fat.Apendix (Extremity) more affected showed less lean mass in LKOA vs EKOA.Funtionality, pain and quality of life is more detrimented by KOA with remark on late knee osteoarthritis.Baseline body composition assesment may predict outcomes in TKA.

References:Sowers, M. F. et al. BMI vs body composition and radiographically defined osteoarthritis of the knee in women: a 4-year follow-up study. Osteoarthritis Cartilage 16, 367–372 (2008). Sharma, L., Dunlop, D. D., Cahue, S., Song, J. & Hayes, K. W. Quadriceps strength and osteoarthritis progression in malaligned and lax knees. Ann. Intern. Med. 138, 613–619 (2003). Lee, S., Kim, T.-N. and Kim, S.-H. (2012), Sarcopenic obesity is more closely associated with knee osteoarthritis than is nonsarcopenic obesity: A cross-sectional study. Arthritis & Rheumatism, 64: 3947–3954. doi: 10.1002/art.37696. Percent Body Fat More Associated with Perioperative Risks After Total Joint Arthroplasty Than Body Mass Index. Ledford, Cameron K. et al. The Journal of Arthroplasty , Volume 29 , Issue 9 , 150 – 154

Funding by CONACYT grant SALUD-2009-01-115275