Protein‐based perioperative nutrition interventions for improving muscle mass and functional outcomes following orthopaedic surgery

Witard, Oliver C., Hughes, Alix K., Morgan, Paul T ORCID: https://orcid.org/0000-0001-7254-4507, Larsen, Mads, Herrod, Phillip J. J., Phillips, Bethan E. and Dhesi, Jugdeep (2025) Protein‐based perioperative nutrition interventions for improving muscle mass and functional outcomes following orthopaedic surgery. Experimental Physiology. ISSN 0958-0670

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Abstract

This narrative review provides an overview of protein‐based perioperative nutrition interventions for improving muscle mass and functional outcomes in patients undergoing orthopaedic surgery. Globally, the number of joint replacement procedures continues to rise annually, with beneficial outcomes in terms of pain relief and quality of life. However, orthopaedic surgery is associated with a transient decline in skeletal muscle mass, strength and function, with resulting impact on balance and posture, mobility and an increased risk of falls during the perioperative period. Perioperative nutrition interventions targeted at mitigating muscle atrophy, strength loss and reduced function in response to orthopaedic surgery have primarily focused on essential amino acid and protein supplementation. Promising results have been observed in patients undergoing total knee arthroplasty, total hip replacement, surgical treatment of hip fracture and anterior cruciate ligament reconstruction. Preliminary evidence also suggests a role for perioperative β‐hydroxy‐β‐methylbutyrate supplementation in improving muscle mass and function outcomes following orthopaedic surgery. However, translation of findings from experimental studies into clinical practice is required.