Sarcopenia: diagnosis, management and its relevance to orthopaedic practice

Abstract

Sarcopenia is a progressive skeletal muscle disorder characterized by age-related loss of muscle mass, strength and function. It is independently associated with adverse clinical outcomes, including fractures, falls, disability and increased mortality. It represents a potentially modifiable surgical risk factor within the broader umbrella of frailty. Diagnosis is based on assessment of muscle strength and function, with or without quantitative measures of muscle mass. Current management strategies focus on resistance exercise and nutritional optimization, predominantly through increased protein intake and targeted amino acid supplementation. The relevance of sarcopenia to orthopaedic practice is increasingly recognized, particularly in patients sustaining fragility fractures and those undergoing elective joint replacement surgery. Orthopaedic surgeons are uniquely positioned to identify sarcopenia through functional assessment and to implement early interventions. Incorporating pre-operative screening and structured prehabilitation programmes may optimize functional reserve and improve post-operative outcomes in sarcopenic patients.