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Nutrients 2018, 10(7), 820; https://doi.org/10.3390/nu10070820

What Is the Role of Nutritional Supplements in Support of Total Hip Replacement and Total Knee Replacement Surgeries? A Systematic Review

1
Orthopaedic Research Institute, Bournemouth University, 6th Floor, Executive Business Centre, 89 Holdenhurst Road, Bournemouth BH8 8EB, UK
2
Department of Kinesiology, McMaster University, Hamilton, ON L8S 4L8, Canada
*
Author to whom correspondence should be addressed.
Received: 5 June 2018 / Revised: 20 June 2018 / Accepted: 21 June 2018 / Published: 25 June 2018
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Abstract

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. View Full-Text
Keywords: nutrition; total hip replacement; total knee replacement; enhanced recovery after surgery; orthopedics nutrition; total hip replacement; total knee replacement; enhanced recovery after surgery; orthopedics
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Burgess, L.C.; Phillips, S.M.; Wainwright, T.W. What Is the Role of Nutritional Supplements in Support of Total Hip Replacement and Total Knee Replacement Surgeries? A Systematic Review. Nutrients 2018, 10, 820.

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