Evidence map›Paper›PMID 40317042›Full record

SynthesisJournal of orthopaedic surgery and research2025

Peri-operative protein or amino acid supplementation for total joint arthroplasty: a systematic review and meta-analysis.

Yashar Khani, Ali Salmani, Mohammad Elahi, Iman Elahi Vahed, Elias Sadooghi Rad, Alireza Bahrami Samani, Shaghayegh Karami, Mohammad Nouroozi, Amir Mehrvar

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Serum parathyroid hormone and risk of sarcopenia: a meta-analysis.Journal of orthopaedic surgery and research · 2025
    Pooled it
  3. Review
  4. Review
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Yashar KhaniStudent Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ali SalmaniStudent Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Mohammad ElahiCenter for Orthopedic Trans-disciplinary Applied Research, Tehran university of medical sciences, Tehran, Iran.
Iman Elahi VahedSchool of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Elias Sadooghi RadStudent Research Committee, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran.
Alireza Bahrami SamaniSchool of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran.
Shaghayegh KaramiSchool of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Mohammad NourooziClinical Research Development Unit (CRDU), Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Amir MehrvarClinical Research Development Unit (CRDU), Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. drmehrvar@sbmu.ac.ir.ORCID http://orcid.org/0000-0002-6661-2275

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeOsteoarthritis (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.

methodsFollowing 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.

resultsNineteen 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.

conclusionsProtein 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 registrationPROSPERO registration code (CRD42024555899).

Indexed as

Amino AcidsArthroplasty, Replacement, HipArthroplasty, Replacement, KneeDietary ProteinsDietary SupplementsMuscular AtrophyPerioperative CareHumansMuscle StrengthAmino AcidsDietary ProteinsAmino acid infusionAmino acid supplementationArthroplastyBranched-chain amino acidsEssential amino acidProtein supplementation

Identifiers

PMID40317042
PMCPMC12046708

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.