Intake of a carbohydrate-containing fluid is reported to improve insulin-like growth factor levels , reduce hunger , nausea , and length of stay , and attenuate the decrease in whole-body insulin sensitivity and endogenous glucose release .
Amino acid supplementation is reported to reduce muscle atrophy and accelerate return of functional mobility .
There is limited evidence for nutritional supplementation in THR and TKR pathways ; however , the low risk profile and potential benefits to adjunctive treatment methods , such as exercise programs , suggest nutritional supplements may have a role .
Optimizing nutritional status pre-operatively may help manage the surgical stress response , with a particular benefit for undernourished , frail , or elderly individuals
Nutritional supplements can influence outcomes for individuals undergoing major surgery , particularly in older persons whose functional reserve is limited .
Accelerating recovery from total hip replacement ( THR ) and total knee replacement ( TKR ) may offer significant benefits .
Therefore , we explored the role of nutritional supplements in improving recovery following THR and TKR .
Multimodal perioperative care plus immunonutrition versus traditional care in total hip arthroplasty: a randomized pilot study
Background Multimodal protocol s of perioperative care may enhance postoperative recovery . However , limited information is available on preoperative immune and carbohydrate (CHO)-enriched drinks in patients undergoing hip arthroplasty . We aim ed to investigate the effect of a multimodal protocol ( ACERTO protocol ) plus preoperative immune nutrition on the length of stay ( LOS ) and the postoperative acute phase response of patients undergoing total hip arthroplasty . Methods Thirty-two patients ( mean age , 58 years ; range , 26–85 years ; 16 males ) were r and omized to receive either the  ACERTO protocol  ( n = 15 , ACERTO Group ) , which consisted of 6 h preoperative fasting for solids , an oral drink ( 200 mL of 12.5 % maltodextrin ) up to 2 h before induction of anesthesia , restricted intravenous fluids ( only 1000 mL of crystalloid fluid after surgery ) and preoperative immune nutrition ( 600 mL/day of Impact - Nestlé , Brazil ) for five days prior to surgery , or traditional care ( n = 17 ; control group ) , which consisted of 6–8 h preoperative fasting , intravenous hydration until the 1st postoperative day and no preoperative immune supplementation . The main endpoint was LOS . C-reactive protein ( CRP ) was the secondary endpoint and was assessed during induction of anesthesia and on postoperative day 2 . Results Neither deaths nor postoperative complications occurred . The median LOS was 3 ( 2–5 ) days in the ACERTO group and 6 ( 3–8 ) days in controls ( P < 0.01 ) . Postoperative CRP was higher in the control group ( P < 0.01 ) . Conclusion The ACERTO multimodal protocol of perioperative care plus preoperative immune nutrition may decrease LOS and postoperative CRP levels in total hip arthroplasty . Trial registration Clinical Trials :
Intake of a carbohydrate-containing fluid is reported to improve insulin-like growth factor levels , reduce hunger , nausea , and length of stay , and attenuate the decrease in whole-body insulin sensitivity and endogenous glucose release .
Amino acid supplementation is reported to reduce muscle atrophy and accelerate return of functional mobility .
There is limited evidence for nutritional supplementation in THR and TKR pathways ; however , the low risk profile and potential benefits to adjunctive treatment methods , such as exercise programs , suggest nutritional supplements may have a role .
Optimizing nutritional status pre-operatively may help manage the surgical stress response , with a particular benefit for undernourished , frail , or elderly individuals
Nutritional supplements can influence outcomes for individuals undergoing major surgery , particularly in older persons whose functional reserve is limited .
Accelerating recovery from total hip replacement ( THR ) and total knee replacement ( TKR ) may offer significant benefits .
Therefore , we explored the role of nutritional supplements in improving recovery following THR and TKR .