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Cellular and morphological changes with EAA supplementation before and after total knee arthroplasty.

Jonathan B Muyskens1, Douglas M Foote1, Nathan J Bigot1

  • 1Department of Human Physiology, University of Oregon, Eugene, Oregon.

Journal of Applied Physiology (Bethesda, Md. : 1985)
|July 26, 2019
PubMed
Summary

Essential amino acid supplementation (EAAs) before and after total knee arthroplasty (TKA) increases satellite cells and improves inflammation markers. This intervention may help mitigate muscle atrophy and sarcopenia in older adults post-surgery.

Keywords:
M1 and M2 macrophageatrophyclinical trialmuscle stem cellsarcopenia

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Area of Science:

  • Muscle physiology and cellular biology
  • Sarcopenia and aging research
  • Surgical recovery and rehabilitation

Background:

  • Muscle atrophy is a significant concern following total knee arthroplasty (TKA), particularly in older adults.
  • The cellular mechanisms underlying muscle atrophy and the potential benefits of essential amino acid supplementation (EAAs) remain unclear.
  • Rapid muscle loss occurs within the first two weeks after TKA.

Purpose of the Study:

  • To investigate the cellular basis of muscle atrophy and atrophy reduction in TKA patients.
  • To examine the effects of essential amino acid supplementation (EAAs) on satellite cells and histological markers of inflammation, recovery, and fibrosis.

Main Methods:

  • Forty-one patients (53-76 years) scheduled for TKA were randomized to ingest 20g of EAAs or placebo twice daily.
  • Supplementation occurred for 7 days before TKA and for 6 weeks after surgery.
  • Muscle biopsies were collected before surgery and at 1 or 2 weeks post-surgery for gene expression and immunohistochemistry analysis.

Main Results:

  • EAA supplementation significantly increased satellite cells before surgery compared to placebo.
  • Gene expression analysis showed differences in myogenic regulatory factors (MyoD, myogenin) between groups post-surgery.
  • M1 macrophage prevalence was lower, and TNF-α levels declined faster in the EAA group post-surgery.

Conclusions:

  • Pre-surgical EAA supplementation increases satellite cell numbers and promotes a more favorable inflammatory environment post-surgery.
  • EAAs may play a crucial role in mitigating muscle atrophy and supporting recovery after TKA.
  • These findings provide mechanistic insights into EAA's benefits and inform strategies against post-surgical sarcopenia.