Importance of nutritional support in the preoperative and postoperative periods of orthopedic surgery

Abstract

Total hip and knee arthroplasty are among the most frequently performed orthopedic procedures worldwide, with projections indicating exponential growth over the coming decades. Although long-term functional outcomes are favorable, the perioperative period is marked by a systemic inflammatory response, protein catabolism, and muscle atrophy—particularly of the quadriceps—that may impair recovery. Perioperative nutritional optimization has emerged as a promising strategy to mitigate surgical stress and enhance rehabilitation. Specific interventions, including essential amino acid supplementation, preoperative carbohydrate loading, and immunonutrition, have shown potential to preserve muscle mass, modulate metabolic response, and reduce postoperative complications. However, the literature remains fragmented, with significant methodological heterogeneity regarding populations, supplementation protocols, and outcome measures, underscoring the need for standardized clinical trials. Current evidence indicates that perioperative nutritional interventions are safe and effective in improving functional and metabolic outcomes after hip and knee arthroplasty. Personalized nutritional strategies tailored to patient characteristics represent a valuable opportunity to establish nutritional support as a standard component of perioperative orthopedic care.