Sarcopenia and Osteoporosis: What Orthopaedic Surgeons Should Know

Sarcopenia, the age-associated loss of skeletal muscle and function, is an integral part of the physical component of the "frailty syndrome". There is evidence that sarcopenia can reach levels where mobility, balance and functionality overall are hampered. So, the diagnosis of sarcopenia should be part of the standard diagnostic and therapeutic repertoire of Geriatric Medicine and Orthogeriatrics. From a pathophysiological point of view, both sarcopenia and frailty share many components, very importantly the one of a low-inflammatory state. The propensity to lack adequate responses to internal and external stresses in frailty, highlights that other domains are involved in this multi-dimensional syndrome. As with muscle mass, bone mass is declining irrespective of gender or life-span. Both Geriatric Medicine and Orthogeriatrics in addition very often deal with patients suffering from fragility fractures due to osteoporosis. In essence, sarcopenia as well as osteoporosis often develop in parallel and the Orthopaedic surgeon seeing elderly persons with fragility fractures is also confronted with sarcopenia and the clinical signs of frailty. In this mainly multi-morbid population, a close interplay between the Orthopaedic surgeons and Geriatricians therefore helps in the management of this fast-increasing population.