Multimodal Nutritional Management in Primary Total Knee Arthroplasty: A Randomized Controlled Trial

Area of Science:

• Orthopedic Surgery
• Nutritional Science
• Anesthesiology

Background:

• Total knee arthroplasty (TKA) is a common orthopedic procedure.
• Maintaining perioperative nutritional status is crucial for patient recovery.
• Traditional protocols may not fully address nutritional needs during TKA recovery.

Purpose of the Study:

• To evaluate the efficacy of a novel multimodal nutritional management (MNM) protocol.
• To assess the impact of MNM on albumin (ALB) transfusion requirements.
• To determine the effect of MNM on electrolyte balance, blood loss, and hospital length of stay (LOH) in TKA patients.

Main Methods:

• A randomized controlled trial involving 162 patients undergoing TKA without a tourniquet.
• Patients were assigned to either the MNM protocol (experimental) or a traditional protocol (control).
• Primary outcomes included ALB transfusion rates, LOH, blood loss, and electrolyte disorder incidence.

Main Results:

• The MNM group required significantly less ALB transfusion and had a shorter LOH.
• Incidence of hypokalemia and hypocalcemia was lower in the MNM group postoperatively.
• Patients on the MNM protocol exhibited higher perioperative levels of ALB, sodium, potassium, and calcium.

Conclusions:

• The MNM protocol effectively reduces ALB transfusion needs and electrolyte disturbances in TKA patients.
• MNM contributes to a shorter hospital stay and better preservation of key nutritional markers.
• This nutritional strategy shows promise for improving outcomes in TKA surgery.