Pre- and Post-Surgical Nutrition for Preservation of Muscle Mass, Strength, and Functionality Following Orthopedic Surgery

Abstract

Nutritional status is a strong predictor of postoperative outcomes and is recognized as an important component of surgical recovery programs. Adequate nutritional consumption is essential for addressing the surgical stress response and mitigating the loss of muscle mass, strength, and functionality. Especially in older patients, inadequate protein can lead to significant muscle atrophy, leading to a loss of independence and increased mortality risk. Current nutritional recommendations for surgery primarily focus on screening and prevention of malnutrition, pre-surgical fasting protocols, and combating post-surgical insulin resistance, while recommendations regarding macronutrient composition and timing around surgery are less established. The goal of this review is to highlight oral nutrition strategies that can be implemented leading up to and following major surgery to minimize atrophy and the resultant loss of functionality. The role of carbohydrate and especially protein/essential amino acids in combating the surgical stress cascade and supporting recovery are discussed. Practical considerations for nutrient timing to maximize oral nutritional intake, especially during the immediate pre- and post- surgical periods, are also be discussed.

Nutritional Strategies in the Rehabilitation of Musculoskeletal Injuries in Athletes: A Systematic Integrative Review

“…Recently, a randomized controlled clinical trial conducted by Juhasz et al (2018) [ 57 ] concluded that CrM supplementation (20 g for 5 days followed by 5 g for the rest of the study) combined with therapeutic strategy effectively supports the rehabilitation of tendon overuse injury of adolescent fin swimmers. A recent systematic review that evaluated pre- and post-surgical nutrition for preservation of muscle mass, strength, and functionality also concluded that CrM supplementation merits consideration in the general population [ 99 ]. In agreement with the collective body of evidence reviewed in this systematic integrative review, we adhere to this recommendation considering the very good safety profile of CrM at doses of 0.1 g/kg/day.…”

Three-dimensional printing designed customized plate in the treatment of coronal fracture of distal humerus in teenager: A case report

“…[ 8 , 13 ] Studies have shown that the probability of elbow stiffness after trauma is at least 5%, and if the range of motion of the elbow is less than 30° to 120°, it will seriously affect orthobiosis. [ 14 ] If functional exercise had been performed after complete healing of the fracturs, the limb is prone to suffer from apraxia osteoporosis, heterotopic ossification, [ 15 ] muscle atrophy around the elbow joint, [ 16 ] and adhesion of the elbow joint derived from hematoma. Therefore, the range of motion and function of the elbow will be remarkably restricted.…”

The effect of pre-operative carbohydrate loading in femur fracture: a randomized controlled trial

“…Due to the occurrence of a more catabolic state during the surgery period, there occurs the destruction of many important inorganic as well as organic elements (for example nitrogen and protein loss) in the body, altering the speed of wound healing [ 52 ]. One of them is the decrement of serum albumin, commonly observed in most patients [ 53 ] which is the result of intense surgical stress predicting increased postoperative complications [ 54 ].…”