| Objective: Both sarcopenia and knee osteoarthritis(KOA)are diseases with increasing age and high prevalence in the elderly population,and with the further increase of aging in China,the number of patients with this disease will further surge in the future.Therefore,it is important to determine easily whether myasthenia gravis exists in KOA patients clinically,and to assess potential risk factors for myasthenia gravis KOA patients.At present,the diagnosis of KOA is mainly based on X-rays,and it is also important to use the imaging information provided by X-rays to assess the condition of KOA patients and provide more reference basis for the prevention and treatment of KOA.There is a clear correlation between the liver and kidney deficiency type and the two in the TCM classification.In this study,we investigated the general distribution of KOA with and without myasthenia gravis in terms of gender,age,and weight,as well as the differences in knee function scores,body composition test results,and knee x-ray angles.It provides a simple basis for the diagnosis of KOA patients with or without sarcopenia.The correlation between body composition test results and knee radiographic angles in KOA with sarcopenia and liver-kidney deficiency was further investigated to investigate the effect of sarcopenia on knee degeneration and to improve the attention to the condition of patients with KOA with sarcopenia,and to provide early interventions.Methods: This study used a cross-sectional study clinical trial design protocol.From January 2021 to January 2022,KOA patients admitted to the outpatient clinic and wards of the Department of Orthopaedics and Traumatology of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine were collected according to the diagnostic criteria and TCM syndromes,and KOA patients with liver and kidney deficiency type and complete data were collected.Body composition tests were performed on the collected cases,and according to the diagnostic criteria of myasthenia gravis,the above-mentioned stowed cases were divided into myasthenia gravis group and non-myasthenia gravis group.Study 1: 1.To investigate the differences in gender,age,weight distribution,calf circumference,muscle strength and number of lower extremities involved in the affected limb between patients with myasthenia gravis and those with non-myasthenia gravis KOA.2 The WOMAC score of the more severe limb was performed,and the scores of pain(5 items),stiffness(2 items),and daily living(17 items)distributed on the table were compared with the total score according to the results.The differences in body mass index(BMI),wasting mass of the affected limb,and bone density of the affected limb between the two groups were compared.4Orthopantomographs of the knee in the upright position and lateral radiographs with the knee flexed at 30° were taken,and the Kellgren-Lawrence rating of the knee joint was measured.Kellgren-Lawrence rating was performed on the knee joint,and the knee gap angle,tibial plateau posterior tilt angle,and patellar height were also measured according to the measurement tools provided by the imaging system.The differences between the sarcopenic group and the non-sarcopenic group were compared for the three measurements of the knee joint.Study 2: Analysis of the correlation analysis between BMI,affected side wasting mass,affected side fat mass,affected side bone mineral mass,affected side bone mineral density and the angular results of knee radiograph measurements in the patients with sarcopenia group in body composition testing.Results: The group of KOA with liver and kidney deficiency was predominantly female,accounting for 94.6%.There was no male group in this study due to non-muscular hypoplasia KOA patients.Therefore,the following results were analyzed only for the data collected from the female group in both groups.Study 1: 1.Statistical analysis of general data showed that the prevalence of sarcopenia in the female group was 72.9% in the liver and kidney deficiency type of KOA.(1)Age: there was no difference in the age distribution between the myasthenia gravis group and the non-myasthenia gravis group(P>0.5),age stratification by 10 years,frequency distribution statistics showed that patients in the myasthenia gravis group were mainly concentrated in the age of 60-69 years accounting for 41.18% of the myasthenia gravis group,and the non-myasthenia gravis population was mainly concentrated in the age of 50-59 years accounting for 42.11% of the non-myasthenia gravis group,and the prevalence of myasthenia gravis with The prevalence of sarcopenia was positively correlated with age growth;(2)weight: patients with sarcopenia were lower than patients with non-sarcopenia,and there was a statistically significant difference P<0.0001,but both exceeded the normal weight,where the average number of non-sarcopenic group was in the obese range;(3)calf circumference and limb muscle strength: patients in the sarcopenic group were lower than those in the non-sarcopenic group,and there was a statistical difference(P<0.05).2.WOMAC score:relative to the non-sarcopenic group,patients in the myasthenia gravis group scored higher on the total WOMAC score as well as on the subitems pain and daily living,and there was a statistical difference between the two(P<0.05).On the stiffness item,there was no statistical difference(P>0.05);3.Body composition test: there was a significant difference(<0.0001)between the group patients in BMI,in the affected limb wasting mass,and in the whole body wasting mass,and there was a statistical difference(P<0.05)in the whole body fat content,fat mass index(FMI),affected limb bone mineral content,affected limb bone mineral content,affected limb bone density,affected limb fat There were no statistical differences in affected limb fat content,affected limb fat percentage,whole-body fat percentage,trunk fat ratio/leg fat ratio,trunk fat mass/leg fat mass,and whole-body bone density.In the comparison of the above results,except for the fat ratio of the affected limb and the fat ratio of the whole body,which were slightly higher in the myasthenia gravis group than in the non-myasthenia gravis group,the measurement results of the other items were lower in the myasthenia gravis group than in the non-myasthenia gravis patients.4.Knee X-ray measurement angle: the myasthenia gravis group was greater than the non-myasthenia gravis group in the KL rating of the knee joint,the knee joint gap angle,and the tibial plateau posterior tilt angle,and the difference was statistically significant P<0.05.In the patella height the two were not statistically different.Study 2: 1.A linear correlation between the results of body composition analysis and knee radiographs showed that the wasting mass of the affected limb was negatively correlated with the knee gap angle,tibial plateau posterior tilt angle and patellar height in patients with myasthenia gravis KOA,and the bone mineral content of the affected limb was negatively correlated with the knee gap angle and tibial plateau posterior tilt angle,but not with patellar height.And BMI,fat mass of the affected limb,and bone mineral density of the affected limb were equal to the results of knee joint measurement angle without correlation.Conclusions: 1.The prevalence of sarcopenia in the KOA group with liver and kidney deficiency was 74.3%,and the prevalence in women was 68.9%,which was much higher than that in men 5.4%;in terms of age,the prevalence of sarcopenia increased with age,and the possibility of sarcopenia should be fully considered in the elderly KOA patients;2.The results of body composition analysis showed that patients with myasthenia gravis KOA were not limited to loss of weight and mass,but also loss of fat and bone mineral in the affected limbs and loss of function of the affected limbs,without any effect on the distribution of body fat.3.The presence of sarcopenia can aggravate knee injuries and alter the angle of knee radiographs in patients with liver-kidney deficiency KOA,and sarcopenia is an adverse factor leading to accelerated KOA degeneration.In patients with KOA with liver and kidney deficiency and sarcopenia,attention should be paid to the patient’s condition and early intervention should be made.5.The decrease in muscle and loss of bone mineral content in the affected limb can lead to further degeneration of the knee joint and alter the normal physiological angle of the knee joint,especially aggravating the degree of inversion of the knee joint.In clinical patients with KOA with liver and kidney deficiency and sarcopenia,attention should be paid to muscle building functional exercises and calcium supplementation of the affected limb. |
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