Apr 29

New Knees: Nutrition Impacts Recovery from Surgery

by Rebecca Morley

As we rack up the years, our joints may suffer to the point that knee replacement surgery is recommended.

Osteoarthritis and rheumatoid arthritis are often the culprits that cause pain, decreased joint mobility and even limit our desire to enjoy an active lifestyle. Visions of long hikes, tennis games, playing a little three-on-three basketball, or dancing the night away may encourage you to take that leap – or limp – into knee replacement surgery.

Historically, physicians request that knee replacement candidates focus on building strength and staying as active as possible. Typical recommendations include balanced nutrition, losing weight for those who might be overweight or obese, smoking cessation, limiting alcohol intake and pre-surgical muscle strengthening. Although you should avoid activities that significantly increase pressure in damaged joints such as using a stair climbing machine, running or intense hiking, being in good physical condition before surgery will aid in the recovery.

New University of Oregon studies on protein intake in the Nov. 13 issue of the Journal of Clinical Investigation could spell relief and speed recovery for baby boomers who face total knee replacement. Twenty grams of essential amino acids taken twice daily for a week before and for two weeksafter knee-replacement surgery helped patients recover faster and with much less muscle atrophy than a control group taking a placebo.

Hans C. Dreyer, a professor of human physiology at the University of Oregon, explained that atrophy in the quadriceps, a group of four muscles on the front of the thigh, has been a long-running problem after kneereplacement surgery.

“We’ve learned that the essential amino acids were able to mitigate the amount of muscle loss,” Dreyer said.

Functional measures such as standing up out of a chair, walking up a flight of stairs and going back down the stairs all improved in the group that received the increased essential amino acid therapy.

Faster recovery is a big plus for knee-replacement patients who have have been dealing with pain for a long time and are eager for relief. And it is welcome news to know that something so easy and relatively inexpensive can help.

Essential amino acids are proteins that are not naturally produced by the human body and must come from food sources. They help the body a variety of ways, including tissue repair. The essential amino acid supplement used in the knee-replacement therapy was composed of rapidly absorbed raw amino acids as a mix of histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine and valine. Supplements were consumed an hour after physical therapy to take advantage of optimum protein synthesis after resistance exercises.

More studies by the University of Oregon are planned to identify the mechanisms of action, the durability of effect, and the safety and potential benefits of longer dosing times. The group also plans to assess the effects of treatment on the quality of life of patients and their engagement in their own health care needs.

Though these studies are exciting, I would be remiss if I did not share the larger picture of nutrition in preparing your body for surgery.

Your body needs to be well-nourished to heal bones, muscles and skin that are affected by surgery. The nutrients from food provide us with the strength, energy and ability to heal. People who are well-nourished overall are less likely to develop infection and heal faster.

Other key nutrients worth highlighting that are important before, during and after your surgery are:

Calcium, to heal your bones and keep them strong. Good sources include milk, yogurt, cheese, canned salmon and sardines (with the bones). Smaller amounts of calcium are also found in beans and lentils, broccoli, kale, bok choy and oranges.

Vitamin D, which helps your body absorb calcium and strengthens your immune system. Most people in Montana need to take a vitamin D supplement because adequate vitamin D is not available from our food, nor is it available from the sun during most months of the year. The good news is that quality vitamin D supplements are inexpensive and readily available. (Consult a health care provider for a vitamin D blood test and to recommend the correct supplement dosage.)

Iron, which is needed to build up hemoglobin in your blood and prevent anemia. Hemoglobin carries oxygen throughout your body. If your hemoglobin level is low, you may feel tired, dizzy and weak, or get short of breath easily. Good sources of iron include meat, fish, poultry, canned oysters, clams, beans, tofu, some leafy green vegetables and fortified whole grains. Non-meat iron-containing foods can be better used by your body by eating foods rich in vitamin C with them.

Vitamin B12 and folate/folic acid, which are important nutrients to prevent other types of non-iron-related anemia. Good sources of vitamin B12 include fish, meat, poultry, eggs, milk and milk products. Good sources of folate/folic acid include leafy green vegetable, dry beans and peas, fortified grains and orange juice. When you are older than 50, you do not absorb vitamin B12 as well as when you were younger, so you need to increase your intake B12-rich foods or take a multivitamin with minerals.

Protein, listed again here because it is so integral to maintain and increase your strength before and after surgery. Protein is a key nutrient for healing. High protein foods include beef, pork, fish, poultry, eggs, milk and dairy products, soy milk, beans, nuts, peanut butter and tofu. Include some protein foods at every meal.

The success of your knee-replacement surgery is dependent upon being prepared both physically and mentally. As your health care provider will discuss with you, knee-replacement surgery is not a simple proceeder, but it can help improve the quality of the years ahead. The willingness to prepare for your surgery in advance coupled with the responsibility for proper post-surgery rehabilitation – including physical therapy – assures a speedier recovery and offers long-term health benefits associated with a more active lifestyle.

Rebecca Morley provides nutrition services through the Eat Smart Program and can be reached at 258-3827 or at rmorely@co.missoula.mt.us.


No comments yet.

Add a comment