What Is the Role of Nutritional Supplements in Support of Total Hip Replacement and Total Knee Replacement Surgeries? A Systematic Review.
Nutritional supplements can influence outcomes for individuals undergoing major surgery, particularly in older persons whose functional reserve is limited. Accelerating recovery from total hip replacement (THR) and total knee replacement (TKR) may offer significant benefits. Therefore, we explored the role of nutritional supplements in improving recovery following THR and TKR. A systematic review was conducted to source randomized clinical trials that tested nutritional supplements in cohorts of THR or TKR patients. Our search yielded nine relevant trials. Intake of a carbohydrate-containing fluid is reported to improve insulin-like growth factor levels, reduce hunger, nausea, and length of stay, and attenuate the decrease in whole-body insulin sensitivity and endogenous glucose release. Amino acid supplementation is reported to reduce muscle atrophy and accelerate return of functional mobility. One paper reported a suppressive effect of beta-hydroxy beta-methylbutyrate, L-arginine, and L-glutamine supplementation on muscle strength loss following TKR. There is limited evidence for nutritional supplementation in THR and TKR pathways; however, the low risk profile and potential benefits to adjunctive treatment methods, such as exercise programs, suggest nutritional supplements may have a role. Optimizing nutritional status pre-operatively may help manage the surgical stress response, with a particular benefit for undernourished, frail, or elderly individuals.
['Burgess|Louise C|LC|0000-0003-1870-9061', 'Phillips|Stuart M|SM|0000-0002-1956-4098', 'Wainwright|Thomas W|TW|']
D000284:Administration, Oral D019644:Arthroplasty, Replacement, Hip D019645:Arthroplasty, Replacement, Knee D001696:Biomechanical Phenomena D019587:Dietary Supplements D006621:Hip Joint D006801:Humans D007719:Knee Joint D053580:Muscle Strength D009752:Nutritional Status D016032:Randomized Controlled Trials as Topic D020127:Recovery of Function D016896:Treatment Outcome
nutrition total hip replacement total knee replacement enhanced recovery after surgery orthopedics