Total Knee Arthroplasty Studies

XR® is currently conducting pilot studies evaluating the impact of targeted nutritional supplementation in Total Knee Arthroplasty healing and recovery.

  • EAA Supplementation on Muscle Mass, Muscle Performance and Functional Capacity in Subjects Undergoing Total Knee Arthroplasty

    Patients who received amino acid supplementation showed:

    • 14% Increase in Isometric Knee Extension Strength
    • 20% Less Quadriceps Atrophy (Ultrasound)
    • 10% Faster Functional Recovery in TUG Test
    • 6% Improvement in Serum Albumin Levels

    (READ THE STUDY HERE)

    EJOST 2024

  • Improved Functional Outcomes Post Total Knee Arthroplasty

    Patients who received Essential Amino Acids (EAA) 1 wk pre-op and 2 wks post TKA had: 

    *2.2 - 4.6X Less quad and hamstring muscle loss (measured by MRI) 

    *30 - 55% Accelerated return of functional recovery post surgery

    (READ THE STUDY HERE)

    Dreyer Clin Invest. 2013

  • Faster Recovery in Total Knee Arthroplasty

    Patients who received Essential Amino Acids 1 wk pre-op and 2 wks post-op showed:

    *2 - 3X Faster Functional Recovery

    *20% Less Quad Atrophy (ultrasound)

    *17% Less Pain (VAS)

    *6% Improved serum albumin

    (READ THE STUDY HERE)

    Ueyama Bone Joint J 2020

  • Preserved Muscle Mass Post Total Knee Arthroplasty

    Patients who received EAA supplementation 1 wk pre-op to 6 wks post-op had significantly less muscle loss in both operated and contralateral leg.

    Quadriceps:

    *Operated leg -8.5% vs. -13.4%

    *Contralateral leg -1.5% vs -7.2%

    Hamstrings: 

    *Operated leg -7.4% vs  -12.2%

    *Contralateral leg -2.1% vs -7.5%

    (READ THE STUDY HERE)

    Dryer JBJS 2019

  • Enhanced Recovery Post Total Knee Arthroplasty

    Patients who received HMB/Arg/Gln Supplementation for 5 days pre surgery and for 28 days post surgery showed:

    *Significantly improved quad strength

    *Improved muscle volume:

    The control group lost 4.3% muscle volume lost after surgery

    VS

    The supplement group GAINED 10% muscle volume

    (READ THE STUDY HERE)

    Nishizaki J Clin Nutr 2015

  • Perioperative Essential Amino Acid Supplementation Facilitates Quadriceps Muscle Strength And Volume Recovery After TKA

    Patients received EAA (9 g/day) supplementation from 1 week pre op to 2 weeks post op.

    EAA group demonstrated significantly increased outcomes at 2 years after surgery.

    *Rectus Muscle Area:

    134% vs 114%

    *Quad Muscle Area:

    159% and 125%

    (READ THE STUDY HERE)

    Ueyama JBJS 2023

  • Commentary & Perspective

    Nutritional Optimization with Amino Acid Supplementation Aids Recovery After Total Knee Arthroplasty

    “Perioperative Essential Amino Acid Supplementation Facilitates Quadriceps Muscle Strength and Volume Recovery After TKA. A Double-Blinded Randomized Controlled Trial”

    (READ THE COMMENTARY HERE)

    Reviewed by: Golladay JBJS 2023

Knee Specialist Research Team

  • Vishal Hedge, MD

    Assistant Professor in the Johns Hopkins Department of Orthopedic Surgery, Director of Clinical Research, Adult Hip and Knee Replacement Division, and Director, Adult Hip and Knee Replacement Fellowship

  • Andrew Harris, MD

    Orthopedic Surgery Resident Physician at The Johns Hopkins Hospital
Explore More Studies

References

  • Dreyer, H.C.; Strycker, L.A.; Senesac, H.A.; Hocker, A.D.; Smolkowski, K.; Shah, S.N.; Jewett, B.A. Essential amino acid supplementation in patients following total knee arthroplasty. J. Clin. Invest. 2013, 123, 4654–4666.
  • Dreyer, H.C.; Owen, E.C.; Strycker, L.A.; Smolkowski, K.; Muyskens, J.B.; Kirkpatrick, T.K.; Christie, A.D.; Kuehl, K.S.; Lantz, B.A.; Shah, S.N.; et al. Essential Amino Acid Supplementation Mitigates Muscle Atrophy After Total Knee Arthroplasty: A Randomized, Double-Blind, Placebo-Controlled Trial. JBJS Open Access 2018, 3, e0006.
  • Ueyama,H, N. Kanemoto,Y. Minoda,Y. Taniguchi,H. Nakamura 2020 Chitranjan S. Ranawat Award:Perioperative essential amino acid supplementation suppresses rectus femoris muscle atrophy and accelerates early functional recovery following total knee arthroplasty A prospective double-blind randomized controlled trial 2020 Bon Joint J
  • Choi, Yong Seon MD, PhD; Cho, Byung Woo MD; Kim, Hye Jin MD; Lee, Yong Suk MD; Park, Kwan Kyu MD, PhD; Lee, Bora MD Effect of Preoperative Oral Carbohydrates on Insulin Resistance in Older Adults Who Underwent Total Hip or Knee Arthroplasty: A Prospective Randomized Trial Journal of the American Academy of Orthopaedic Surgeons: May 13, 2022 - Volume - Issue - 10.5435/JAAOS-D-21-00656
  • Shin, Seokyung MD, PhD; Choi, Yong Seon MD, PhD; Shin, Hyejung MS; Yang, Ick Hwan MD, PhD; Park, Kwan Kyu MD, PhD; Kwon, Hyuck Min MD, PhD; Kang, Byunghag MD; Kim, So Yeon MD, PhD Preoperative Carbohydrate Drinks Do Not Decrease Postoperative Nausea and Vomiting in Type 2 Diabetic Patients Undergoing Total Knee Arthroplasty—A Randomized Controlled Trial Journal of the American Academy of Orthopaedic Surgeons: January 1, 2021 - Volume 29 - Issue 1 - p 35-43
  • Kadado, Allen; Shaw, Jonathan H.; Ayoola, Ayooluwa S.; More Effects of Preoperative Carbohydrate-rich Drinks on Immediate Postoperative Outcomes in Total Knee Arthroplasty: A Randomized Controlled Trial Journal of the American Academy of Orthopaedic Surgeons. 30(11):e833-e841, June2022.
  • Muyskens JB, Foote DM, Bigot NJ, Strycker LA, Smolkowski K, Kirkpatrick TK, Lantz BA, Shah SN, Mohler CG, Jewett BA, Owen EC, Dreyer HC. Cellular and morphological changes with EAA supplementation before and after total knee arthroplasty. J Appl Physiol (1985). 2019 Aug 1;127(2):531-45.
  • Dreyer, H.C.; Strycker, L.A.; Senesac, H.A.; Hocker, A.D.; Smolkowski, K.; Shah, S.N.; Jewett, B.A. Essential amino acid supplementation in patients following total knee arthroplasty. J. Clin. Invest. 2013, 123, 4654–4666. [CrossRef]
  • Dreyer, H.C.; Owen, E.C.; Strycker, L.A.; Smolkowski, K.; Muyskens, J.B.; Kirkpatrick, T.K.; Christie, A.D.; Kuehl, K.S.; Lantz, B.A.; Shah, S.N.; et al. Essential Amino Acid Supplementation Mitigates Muscle Atrophy After Total Knee Arthroplasty: A Randomized, Double-Blind, Placebo-Controlled Trial. JBJS Open Access 2018, 3, E0006.
  • Kennedy DM, Stratford PW, Hanna SE, Wessel J, Gollish JD. Modeling early recovery of physical function following hip and knee arthroplasty. BMC Musculoskelet Disord. 2006;7:100.