Impact of Pre-operative Sarcopenia on Functional Recovery After Hip Arthroplasty in Older Adults

Summary

This single-centre, exploratory study at Montpellier University Hospital will investigate whether having low muscle mass and strength before hip-replacement surgery, a condition called sarcopenia, impact the return to everyday independence in people aged 75 years or older. About 20 volunteers, scheduled for surgery because of a recent femoral-neck fracture or severe arthritis that no longer responds to usual care, will give consent, answer brief health questionnaires, attempt simple walking and chair-rise tests if possible, and provide a small blood sample. While they are already under anaesthesia for their planned operation, the surgical team will take a tiny muscle sample through the same incision, so no extra cuts are needed. During the hospital stay or shortly after discharge, each participant will have a painless MRI scan of the thigh muscles and a very-low-dose bone scan (DXA) to measure muscle and bone health. The research team will then telephone participants at 3 and 6 months to ask about daily activities, walking ability, and any complications. The study lasts about six months for each person and does not alter their usual medical or rehabilitation care. Potential benefits include close follow-up, personalised feedback on muscle and bone results, and helping doctors learn whether pre-surgery muscle weakness predicts slower recovery-information that could guide future, more personalised exercise and nutrition programs. Extra study procedures carry only minimal risks: a routine blood draw, scans with none (MRI) or very little (DXA) radiation, and a muscle biopsy taken during surgery. Taking part is entirely voluntary, and participants may withdraw at any time without affecting their current or future care. The whole project will run for 18 months.

Eligibility

Inclusion Criteria:

\- Elderly subjects undergoing surgical hip replacement for fracture of the upper end of the femur or severe hip osteoarthritis.

Exclusion Criteria for both groups :

* Contraindications to MRI : pacemaker, metallic implants.
* Presence of a lower-limb prosthesis on the contralateral side to the surgery that may interfere with quadriceps mass measurements.
* Progressive high-grade neoplasia.
* Documented major cognitive disorders
* Under legal protection measures (guardianship, conservatorship, or curatorship).
* Subjects not affiliated with or not covered by a social security system.
* Participation in another ongoing study with an active exclusion period.

Exclusion criteria - Fracture group :

* Fracture with a suspicion of underlying neoplasia.
* Placement of a lower-limb prosthesis on the surgical side within the last 12 months.
* Inability to walk with or without human/technical assistance prior to fracture.

Exclusion criteria - Hip osteoarthritis group :

\- Active inflammatory joint disease (rheumatoid arthritis, spondyloarthritis).

Conditions4

Interventions3

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