AI Summary & Key Takeaways
AI InsightGreater physician awareness ofrisk factors associated with musculoskeletal complications ofCLD patients would yield earlier interventions, lower healthcarecosts, and better overall clinical outcomes for this group ofpatients.
📌 3 Key Takeaways
Abstract
Chronic liver disease (CLD) is the commonest ailment affectingthe hepatobiliary system. Six significant pathologies related toCLD include hepatic osteodystrophy (HO), increased infectionsusceptibility, sarcopenia, osteonecrosis of the femoral head(OFH), increased risk of periprosthetic complications andfracture. Hepatic osteodystrophy, which comprises osteopenia,osteoporosis, and osteomalacia, refers to alterations in bonemineral metabolism found in patients with CLD. The HOprevalence ranges from 13 to 95%. Low complement levels,poor opsonization capacity, portosystemic shunting, decreasedalbumin levels, and impaired reticuloendothelial system makethe cirrhotic patients more susceptible to developing infectiousdiseases. Septic arthritis, osteomyelitis, prosthetic jointinfection, and cellulitis were common types of CLD-associatedinfectious conditions. The incidence of septic arthritis is1.5 to 2-fold higher in patients with cirrhosis. Sarcopenia, alsoknown as muscle wasting, is one of the frequently overlookedmanifestations of CLD. Sarcopenia has been shown to beindependent predictor of longer mechanical ventilation, hospitalstay, and 12-month mortality of post-transplantation. Alcoholand steroid abuse commonly associated with CLD are thetwo most important contributory factors for non-traumaticosteonecrosis. However, many studies have identified cirrhosisalone to be an independent cause of atraumatic osteonecrosis.The risk of developing OFH in cirrhosis patients increases by2.4 folds and the need for total hip arthroplasty increases by10 folds. Liver disease has been associated with worse outcomesand higher costs after arthroplasty. Cirrhosis is a risk factor forarthroplasty complications and is associated with a prolongedhospital stay, higher costs, readmission rates, and increasedmortality after arthroplasty. Greater physician awareness ofrisk factors associated with musculoskeletal complications ofCLD patients would yield earlier interventions, lower healthcarecosts, and better overall clinical outcomes for this group ofpatients.