ArticleFrontiers in medicine2026
Preoperative ultrasound to identify prefrailty or mild cognitive impairment in patients undergoing total hip/knee replacement: a single-center, prospective, cohort pilot study.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: To identify prefrailty and mild cognitive impairment (MCI) in patients undergoing total hip/knee replacement using preoperative ultrasound measurements of muscle dimensions and stiffness. Methods: This pilot study was conducted at a large tertiary public hospital in Beijing, China, and included 121 consecutive patients with hip or knee osteoarthritis scheduled for total hip or knee replacement [median age 71 years, interquartile range (IQR) 5 years; 94 women, 77.7%]. Preoperative assessments included measurements of the dimensions and stiffness of the biceps brachii (BB) using grey scale ultrasound (US) and shear wave elastography (SWE). Patients were preoperatively assessed for prefrailty and mild cognitive impairment (MCI) based on FRAIL scale and Montreal Cognitive Assessment (MoCA) combined with the Clinical Dementia Rating Scale (CDR). Prospective subgroup analyses stratified by gender were performed to identify parameters with statistically significant differences between the non-prefrail and prefrail groups, as well as between the non-MCI and MCI groups. Results: Subgroup analysis by gender showed that thickness of BB on both dominant and non-dominant side in prefrail group from male patients were significantly lower than that in non-frail group. The thickness of the BB on the non-dominant side in predicting prefrailty among male patients had the highest AUC (0.824, 95% CI: 0.627-1.000), with an optimal cut-off value of 1.85 cm, achieving sensitivity of 77.8%, specificity of 66.7%. However, this finding is exploratory given the small male prefrail subgroup ( Conclusion: In this pilot study, preoperative US measurements of BB thickness demonstrated preliminary promise for predicting prefrailty among male patients undergoing total hip/knee replacement. These findings are hypothesis-generating and require confirmation in larger, independent cohorts. However, this approach showed limited utility in female participants and was not effective in predicting MCI.
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