ReviewJournal of clinical orthopaedics and trauma2025
A systematic review and meta-analysis of preoperative carbohydrate drink loading prior to elective hip and knee arthroplasty.
Review in Journal of clinical orthopaedics and trauma, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The effect of perioperative oral carbohydrate loading on postoperative outcomes in patients undergoing orthopedic surgeries: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2026Pooled it
- The effect of preoperative oral carbohydrate intake on perioperative well-being in patients undergoing hip and lower extremity orthopedic surgery under spinal anesthesia: a randomized controlled trial.Langenbeck's archives of surgery · 2025Trial
- The impact of pre-operative oral carbohydrate loading on peri-operative outcomes: A systematic review and meta-analysis of randomised controlled trials.Indian journal of anaesthesia · 2026Article
- Impact of integrating Quality Control Circle, Disease-Specific Care Certification and Enhanced Recovery After Surgery on perioperative outcomes in joint replacement.BMJ open quality · 2026Article
- Perioperative Interventions Based on Fasting Protocols and Carbohydrate Loading in Non-Cardiac Surgery in Older Adults: A Scoping Review.Medicina (Kaunas, Lithuania) · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The Enhanced Recovery After Surgery (ERAS) program has significantly reduced complication rates and hospital length of stay (LOS) for various surgical procedures. A key aspect is the reduction of pre-operative fasting through carbohydrate-loading protocols. There is limited research on the effects of pre-operative carbohydrate loading in elective lower limb arthroplasty. This systematic review and meta-analysis evaluates the impact of pre-operative carbohydrate loading on LOS, pain scores, postoperative nausea and vomiting, patient-reported outcome measures (PROMs), and patient experience in lower limb arthroplasty surgery. Methods: The MEDLINE, Embase, CINAHL, and Cochrane Central databases underwent a comprehensive search from their inception to July 01, 2023, with an update conducted on April 01, 2024. Inclusion criteria encompassed high-quality research as determined by the AMPQQ assessment tool, focusing on preoperative carbohydrate drink loading in hip and knee arthroplasty. The review was prospectively registered on PROSPERO; registration number CRD42023420618. Results: 1686 articles were identified. 281 duplicates were removed and 1379 articles rejected based on title and abstract review. 26 articles underwent a full-text review. A final evaluation was conducted, which included 10 articles meeting the inclusion criteria. These articles, published between 2001 and 2022, encompassed 756 patients (57-71.9 years old). While some studies indicated the potential benefits of carbohydrate loading in reducing the length of hospital stay (LOS), our meta-analysis did not demonstrate a statistically significant LOS reduction within the intervention group (mean difference of 0.47 days (95 % CI -0.98 to 0.04, p = 0.07). Furthermore, no statistically significant differences were observed in pain scores (VAS) at 24 h (p = 0.37) or in postoperative nausea and vomiting (p = 0.42) between the two groups. However, there is a possibility of improvement in anxiety levels, postoperative thirst, and hunger with carbohydrate drink loading. Conclusion: LOS trended towards favouring pre-operative carbohydrate loading in lower limb arthroplasty surgery, however, there was significant heterogeneity within included studies. Further high-powered, multicentered studies are required to analyse whether carbohydrate drink loading is superior to 'nil by mouth' protocols.
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