Poster 363: Post-Operative Protein Supplementation following Orthopaedic Surgery: A Systematic Review

Objectives: Decreased mechanical loading after orthopaedic surgery predisposes patients to develop muscle atrophy. The purpose of the study was assess whether oral protein supplementation can help decrease postoperative atrophy and/or improve patient outcomes following surgery. Methods: A systematic review literature performed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. registered with Prospective Register (PROSPERO). search PROSPERO registration did not identify similar prior reviews or meta-analyses. Databases were searched during April 2021 included: MEDLINE (Pubmed), Embase, Scopus, Web Science. Each contained a combination terms: “orthopaedic procedures” AND “protein” OR “amino acid” “dietary supplements” “supplementation” “supplement.” Orthopaedic procedures listed individually using PubMed index procedures, as well mesh function extract articles keywords. Eligibility Criteria principal inclusion criteria consisted randomized controlled trials evaluating amino acid regimens measure counteract Articles that evaluated other forms dietary non-orthopaedic excluded. Control groups included either placebo natural history control (i.e. routine post-operative protocol). scope intentionally left broad, allow comparison effectiveness across different surgical interventions. study’s reference list manually reviewed additional prevent unintentional exclusion studies. Two reviewers independently assessed all identified by strategy applied eligibility criteria. Data Extraction content extracted from each article (1) demographic data, (2) supplement regimen used, (3) outcomes, (4) complications, (5) length follow up. Primary functional physiologic measures strength. Secondary satisfaction time return sport work. Analysis Quality assessment studies Modified Coleman Methodology Scoring (MCMS). Heterogeneity design noted including differences in protocols, measurement techniques, measured, which prevented an adequate statistical meta-analysis. Results: Fourteen 611 (224 male, 387 female) analyzed (Figure 1). Four cohorts identified: Anterior cruciate ligament reconstruction (ACLR), total hip arthroplasty (THA), fractures (THA, revision THA, resurfacing), knee (TKA). ACLR, fracture composed 3 studies, while there 5 TKA cohort. Average follow-up 9 weeks 7 10 fracture, TKA. Protein various combinations essential acids tablet form whey powder. Placebo supplements most commonly isocaloric carbohydrate reported have beneficial effects types surgeries. primary benefit decreased measured cross sectional area. significant difference observed final week majority (average up 8 weeks). Multiple also demonstrated improved measures, increased isokinetic Of note, participants involved some formal physical therapy varying durations surgery, but this standardized There no increases side comparing controls. investigations, only 2 (both fracture) had diet. MCMS scores cohort follows: ACLR 55 (fair), THA 46 (poor), 44 (poor). Conclusions: In conclusion, appears on mitigating period TKA, treatment fracture. This response often correlates quicker achievement rehabilitation benchmarks. Further research is needed establish guidelines improving clinical period.