Nutrition and Supplements
Surgery places increased demands on your body. Good nutrition before and after surgery provides the building blocks needed to maintain muscle, support tissue repair, and participate effectively in rehabilitation.
Supplements are not a substitute for a healthy diet, physical preparation, or your rehabilitation program. However, certain nutritional strategies may be useful for selected patients.
Protein and Essential Amino Acids
Protein provides the amino acids your body uses to maintain and rebuild muscle and other tissues. This is particularly important after orthopedic surgery, when pain, decreased activity, and temporary immobilization can contribute to loss of muscle mass.
Research in orthopedic surgery suggests that perioperative essential amino acid (EAA) supplementation may help reduce postoperative muscle loss. Some studies have also demonstrated improvements in muscle strength or recovery, although results are not uniform across all procedures and clinical outcomes.
For most patients, the first goal is adequate dietary protein from foods such as:
Fish, poultry, eggs, and lean meats
Greek yogurt, cottage cheese, milk, and other dairy products
Beans, lentils, tofu, and other plant proteins
Protein shakes or supplements when dietary intake is inadequate
Patients who have difficulty meeting their nutritional needs or who are at risk for muscle loss may benefit from a more individualized protein or essential-amino-acid strategy.
Vitamin D
Vitamin D is important for bone metabolism, skeletal muscle function, and normal immune function. Vitamin D deficiency is common in orthopedic patients. Studies have associated low vitamin D levels with poorer outcomes after several orthopedic procedures, including joint replacement and other musculoskeletal surgery. However, an important distinction should be made: having vitamin D deficiency and correcting that deficiency is different than taking extra vitamin D when your level is already adequate.
Current research does not establish that routine high-dose vitamin D supplementation improves surgical outcomes in every patient. When appropriate, we may therefore recommend checking a vitamin D level and correcting a documented deficiency rather than automatically giving high-dose supplementation to everyone.
HMB, Arginine, Glutamine, and “Recovery” Formulas
Some specialized nutritional supplements contain compounds such as:
HMB (beta-hydroxy-beta-methylbutyrate)
Arginine
Glutamine
Essential or branched-chain amino acids
These nutrients have biologic roles in muscle metabolism, wound healing, or immune function, and specialized nutritional formulas have shown benefits in certain surgical populations. The orthopedic evidence is developing, however, and these products should not be considered necessary for every sports-medicine procedure. Their potential value may be greater in patients who are older, nutritionally depleted, losing muscle mass, or expected to experience a substantial period of limited activity.
What About Collagen, Creatine, Fish Oil, and Other Supplements?
Many supplements marketed for joint, tendon, or muscle health have plausible biologic effects. We are overall supportive of supplements such as creatine, collagen protein, and fish oil for general health, however, evidence that taking them specifically around the time of orthopedic surgery improves healing or surgical outcomes remains limited.
For this reason, we generally prioritize:
Adequate overall nutrition
Adequate protein intake
Correction of identified nutritional deficiencies
Appropriate rehabilitation and progressive loading
Individualized supplementation when there is a specific reason to use it
Important: Tell Us Everything You Take
“Natural” does not necessarily mean safe around surgery. Some vitamins, herbal preparations, fish-oil products, and other supplements can affect bleeding, blood pressure, anesthesia, or prescription medications. Please give your surgical team a complete list of every medication, vitamin, supplement, herbal product, and performance or recovery product you take. Do not start a new supplement immediately before surgery—or stop an important medication or prescribed supplement—without discussing it with your surgical team.
The Goal: Build a Better Environment for Recovery
There is no single supplement that guarantees better healing. The goal of preoperative nutrition is to enter surgery with adequate nutritional reserves, maintain as much muscle as possible, correct important deficiencies, and give your body the resources it needs for rehabilitation. Your nutritional plan may be different depending on your age, diet, medical conditions, laboratory results, procedure, and expected postoperative activity restrictions. Please contact our office directly with any questions regarding nutritional supplementation around the time of your surgery.