Feasibility of a Preoperative Exercise and Nutritional Intervention in Sarcopenic Obese Individuals Undergoing Hip or Knee Arthroplasty: A Pilot Randomized Controlled Trial.

This was a pilot feasibility study with 40 randomized patients and no hypothesis testing, so it cannot establish whether the intervention works. Only 25 randomized patients completed the preoperative protocol, and dropouts were linked to surgery timing and COVID-19 scheduling. The participants were likely more motivated than patients who declined, because lack of interest and motivation were common reasons for nonparticipation. Among 31 patients with complete baseline data, only 1 had confirmed sarcopenia on DEXA, so the group is better described as obesity with muscle weakness. The intervention combined usual care, supervised exercise, and tailored nutritional counseling, so the contribution of any single component cannot be separated. The authors noted that the short intervention duration may have limited detectable changes in body composition. Missing data were common for blood markers, food intake, and scans, mainly because of early dropout or equipment issues.

The investigators reported no financial or nonfinancial disclosures.

Do not conclude that supervised exercise alone improves postoperative recovery. The intervention group received usual care plus supervised resistance and aerobic exercise plus tailored nutritional counseling. This was a small pilot with no hypothesis testing, and postoperative outcomes did not differ clearly.