Peri-operative protein or amino acid supplementation for total joint arthroplasty: a systematic review and meta-analysis
Abstract Purpose Osteoarthritis (OA) affects weight-bearing joints, such as hips and knees, and its prevalence is rising due to factors like obesity and aging. Muscle atrophy, exacerbated by aging and surgery, increases the risk of joint instability and falls. Orthopedic surgeons explore dietary int...
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| Format: | Article |
| Language: | English |
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BMC
2025-05-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | https://doi.org/10.1186/s13018-025-05847-4 |
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| author | Yashar Khani Ali Salmani Mohammad Elahi Iman Elahi Vahed Elias Sadooghi Rad Alireza Bahrami Samani Shaghayegh Karami Mohammad Nouroozi Amir Mehrvar |
| author_facet | Yashar Khani Ali Salmani Mohammad Elahi Iman Elahi Vahed Elias Sadooghi Rad Alireza Bahrami Samani Shaghayegh Karami Mohammad Nouroozi Amir Mehrvar |
| author_sort | Yashar Khani |
| collection | DOAJ |
| description | Abstract Purpose Osteoarthritis (OA) affects weight-bearing joints, such as hips and knees, and its prevalence is rising due to factors like obesity and aging. Muscle atrophy, exacerbated by aging and surgery, increases the risk of joint instability and falls. Orthopedic surgeons explore dietary interventions to counteract these effects, with protein supplementation (PS) showing promise. This systematic review and meta-analysis assessed the effectiveness of PS in arthroplasty patients, comparing findings with sports medicine and sarcopenia literature. Methods Following PRISMA guidelines, we searched PubMed, Web of Science, Scopus, and Embase (February 2025) for protein and amino acid supplementation studies in total knee or hip arthroplasty (TKA and THA) patients. The quality assessment used the Cochrane risk of bias and the Newcastle–Ottawa Scale. Meta-analysis calculated effect sizes for muscle atrophy and strength outcomes. Results Nineteen studies (903 patients) evaluated oral or intravenous protein/amino acid supplementation over a mean follow-up of 55.2 days. Essential amino acids (EAA) significantly reduced muscle atrophy in quadriceps femoris muscle mass (SMD: 0.69; 95% CI: 0.44 to 0.95) and hamstring muscle mass (SMD: 1.04; 95% CI: 0.52 to 1.55). However, effects on intramuscular adipose tissue (IMAT) and muscle thickness (MT) were inconsistent. Muscle strength outcomes varied, with no significant effect on quadriceps muscle strength (QMS) or handgrip strength (HGS). Intravenous amino acid infusion improved muscle protein synthesis and reduced perioperative blood loss. Conclusions Protein and amino acid supplementation can reduce muscle atrophy in hip or knee arthroplasty patients. While effects on muscle strength and function are mixed, intravenous supplementation offers benefits. Further standardized research is needed to confirm these findings. Trial registration PROSPERO registration code (CRD42024555899). |
| format | Article |
| id | doaj-art-b75b7ae49617492f9c8f79b8720db2e2 |
| institution | Kabale University |
| issn | 1749-799X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj-art-b75b7ae49617492f9c8f79b8720db2e22025-08-20T03:52:23ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-05-0120111610.1186/s13018-025-05847-4Peri-operative protein or amino acid supplementation for total joint arthroplasty: a systematic review and meta-analysisYashar Khani0Ali Salmani1Mohammad Elahi2Iman Elahi Vahed3Elias Sadooghi Rad4Alireza Bahrami Samani5Shaghayegh Karami6Mohammad Nouroozi7Amir Mehrvar8Student Research Committee, Shahid Beheshti University of Medical SciencesStudent Research Committee, Shahid Sadoughi University of Medical SciencesCenter for Orthopedic Trans-disciplinary Applied Research, Tehran university of medical sciencesSchool of Medicine, Shahid Beheshti University of Medical SciencesStudent Research Committee, Faculty of Medicine, Birjand University of Medical SciencesSchool of Medicine, Qazvin University of Medical SciencesSchool of Medicine, Tehran University of Medical SciencesClinical Research Development Unit (CRDU), Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical SciencesClinical Research Development Unit (CRDU), Taleghani Hospital, Shahid Beheshti University of Medical SciencesAbstract Purpose Osteoarthritis (OA) affects weight-bearing joints, such as hips and knees, and its prevalence is rising due to factors like obesity and aging. Muscle atrophy, exacerbated by aging and surgery, increases the risk of joint instability and falls. Orthopedic surgeons explore dietary interventions to counteract these effects, with protein supplementation (PS) showing promise. This systematic review and meta-analysis assessed the effectiveness of PS in arthroplasty patients, comparing findings with sports medicine and sarcopenia literature. Methods Following PRISMA guidelines, we searched PubMed, Web of Science, Scopus, and Embase (February 2025) for protein and amino acid supplementation studies in total knee or hip arthroplasty (TKA and THA) patients. The quality assessment used the Cochrane risk of bias and the Newcastle–Ottawa Scale. Meta-analysis calculated effect sizes for muscle atrophy and strength outcomes. Results Nineteen studies (903 patients) evaluated oral or intravenous protein/amino acid supplementation over a mean follow-up of 55.2 days. Essential amino acids (EAA) significantly reduced muscle atrophy in quadriceps femoris muscle mass (SMD: 0.69; 95% CI: 0.44 to 0.95) and hamstring muscle mass (SMD: 1.04; 95% CI: 0.52 to 1.55). However, effects on intramuscular adipose tissue (IMAT) and muscle thickness (MT) were inconsistent. Muscle strength outcomes varied, with no significant effect on quadriceps muscle strength (QMS) or handgrip strength (HGS). Intravenous amino acid infusion improved muscle protein synthesis and reduced perioperative blood loss. Conclusions Protein and amino acid supplementation can reduce muscle atrophy in hip or knee arthroplasty patients. While effects on muscle strength and function are mixed, intravenous supplementation offers benefits. Further standardized research is needed to confirm these findings. Trial registration PROSPERO registration code (CRD42024555899).https://doi.org/10.1186/s13018-025-05847-4ArthroplastyAmino acid supplementationProtein supplementationAmino acid infusionEssential amino acidBranched-chain amino acids |
| spellingShingle | Yashar Khani Ali Salmani Mohammad Elahi Iman Elahi Vahed Elias Sadooghi Rad Alireza Bahrami Samani Shaghayegh Karami Mohammad Nouroozi Amir Mehrvar Peri-operative protein or amino acid supplementation for total joint arthroplasty: a systematic review and meta-analysis Journal of Orthopaedic Surgery and Research Arthroplasty Amino acid supplementation Protein supplementation Amino acid infusion Essential amino acid Branched-chain amino acids |
| title | Peri-operative protein or amino acid supplementation for total joint arthroplasty: a systematic review and meta-analysis |
| title_full | Peri-operative protein or amino acid supplementation for total joint arthroplasty: a systematic review and meta-analysis |
| title_fullStr | Peri-operative protein or amino acid supplementation for total joint arthroplasty: a systematic review and meta-analysis |
| title_full_unstemmed | Peri-operative protein or amino acid supplementation for total joint arthroplasty: a systematic review and meta-analysis |
| title_short | Peri-operative protein or amino acid supplementation for total joint arthroplasty: a systematic review and meta-analysis |
| title_sort | peri operative protein or amino acid supplementation for total joint arthroplasty a systematic review and meta analysis |
| topic | Arthroplasty Amino acid supplementation Protein supplementation Amino acid infusion Essential amino acid Branched-chain amino acids |
| url | https://doi.org/10.1186/s13018-025-05847-4 |
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