RESULTS
Within the scope of the study, a total of 152 individuals; 117 patients who were admitted to the physical therapy and rehabilitation outpatient clinic with knee pain who were also diagnosed with knee osteoarthritis, and 35 healthy individuals as control group were examined. Fifteen OA patients and two of kontrol individuals were excluded. A total of 135 individuals were evaluated with the EWGSOP diagnostic criteria for the presence of sarcopenia. Twelve (11.8%) of 102 patients with osteoarthritis were sarcopenic. There were no sarcopenic individuals in the control group. OA patients with sarcopenia constituted the first group(Group 1) , non-sarcopenic OA patients constituted the second group (Group 2) , and controls healty individuals constituted the third group (Group 3). Distribution of some descriptive characateristics among study groups are presented in Table 1. The weight, BMI, waist circumference, hip circumference, upper-middle arm circumference, thigh and leg circumference of patients group 1 were statistically lower than the group 2 and group 3. (p <0.01-p0.001). In the non-sarcopenic osteoarthritis group, weight and height of the patients were lower than the control group. Biceps, triceps, and thigh extensor surface measurements were found to be less in the group with sarcopenia than in the other groups (p <0.001-p = 0.002). Bilateral hand grip strength and gait speed of sarcopenic patients were found to be statistically lower than non-sarcopenic and control groups. All of the patients group 1 were at a low level in the physical activity assessment questionnaire. Thirty eight of the patients with group 2 were at a low level, 44 were at a moderate level, 8 were at a very active level. Twenty one individuals of the group 3 were at a low level, 9 were at a moderate level and 3 were found to be doing very active physical activity. The metabolic equivalents (METs) values obtained from IPAQ-SF were also calculated as min/week (Table 2). The METs values were found to be statisticall lower in the group 1 compared to the group 2 (p = 0.017). The mean MNA score was found to be statistically significantly lower in the group 1 compared to the other two groups (p <0.001) (Table 2). In the CES-D evaluation, the score was calculated as 25.58 ± 11.73 (5-52) in the sarcopenic group, 22.47 ± 14.07 (4-54) in the group 2 and 15.15 ± 10.85 (0-49) in the group 3 (Table 2).
When OA groups with and without sarcopenia were evaluated with the WOMAC score and the WOMAC pain and stiffness values were compared, it was found that there was no significant difference between the sarcopenic and non-sarcopenic osteoarthritis groups (p> 0.05). When the WOMAC physical function scores were compared, a significant difference was found between the groups (p <0.05). The WOMAC total scores were statistically higher in the sarcopenic group than in the non-sarcopenic osteoarthritis group (p = 0.006).
The pain that was experienced by patients at night, on the move and at rest were compared with VAS and no significant difference between groups were found No statistically significant difference was found between the group1 and 2 in the calculated sub-parameters of SF-36 used to evaluate the quality of life (p> 0.05).
When laboratory parameters were evaluated, calcium levels of patients group 1 were statistically lower than group 2 (p = 0.023), leptin (p = 0.720), adiponectin (p = 0.068) and vitamin D (p = 0.285) levels were not detected as statistically significant. In the comparison between the sarcopenic patients and the control group, vitamin D levels were found to be statistically significantly higher in the control group (p = 0.030). Albumin levels in the control group (p = 0.035) were found to be lower than the other two groups (Table 3).
When body composition parameters measured by DEXA, were compared in patients with and without sarcopenic OA and the control group, sarcopenic patients had statistically significantly lower fat masses, lean dry weights and SMI values (p <0.001, p = 0.001, p0.001, respectively), where as sarcopenic patients’ FMI values (p = 0.012) were found to be lower in patients than group2 and 3. In the group 2 , it was found that the fat percentage and LBMI values (p <0.001, p = 0.002) were higher than the other two groups (Table 4).
When the study groups were compared in terms of muscle strength measured by the isokinetic dynamometer, average knee extension forces at 60° / sec angular velocity for the right and left knee were lower in the sarcopenic group when evaluated in terms of peak torque values (p <0.001, p0.001, and the ratio of peak torque to body weight (p = 0.007 and p = 0.031, respectively). In the group 1 , right knee flexion forces at 180 degrees angular velocities and peak torque values were statistically significantly lower (p = 0.038) than group 2 and 3.. Bilateral gastrocnemius medius fascicle lengths and right gastrocnemius medius pennate angles of sarcopenic patients were found to be statistically significantly lower than non-sarcopenic and control groups. Right gastrocnemius medius muscle thickness was significantly decreased in the sarcopenic group compared to the non-sarcopenic group (p = 0.014). Left gastrocnemius medius muscle thickness was higher and rectus abdominis muscle thickness was statistically significantly lower in the non-sarcopenic group compared to the other study groups (p = 0.025 and p = 0.001. It was determined that there was no significant difference between the bilateral rectus femoris subcutaneous tissue thickness and muscle thickness between the groups (p> 0.05)