Nutrition in Surgery: An Orthopedic Perspective
Joseph J. Kavous, MD | Thomas M. Zink, MD | Suzanne E. Kent, MD | Arjun N. Choudhary, BA
Link to the full study on THE JOURNAL OF BONE AND JOINT SURGERY (JB&JS) (noted this is behind a paywall, for a summary and key insight read below)
Current Insights on Nutrition in Orthopedic Surgery
A comprehensive review from the Journal of Bone and Joint Surgery provides crucial insights on the role of nutrition in orthopedic surgery. The study, led by experts including Joseph J. Kavolus, MD, Thomas M. Zink, MD, and Suzanne E. Kent, MD, reveals key findings:
Malnutrition and Orthopedic Surgery
Prevalence: Malnutrition is common in patients undergoing orthopedic surgery, particularly among the elderly and those with orthopedic trauma.
Risks: Malnutrition is linked to increased risks of postoperative complications like wound-healing issues, infections, and even mortality.
Evaluating Nutritional Status
Serologic Markers: Albumin, prealbumin, transferrin, and total lymphocyte count are used to assess nutritional status.
Anthropometric Measures: Body mass index (BMI), calf circumference, and triceps fold size offer additional perspectives on a patient's nutritional health.
Nutritional Intervention Strategies
Supplementation Needs: Increased caloric and protein intake is recommended during the perioperative period.
Types of Supplements: Protein-calorie, amino acid, and immunonutrition supplements are beneficial, with vitamin D supplementation as an area for further study.
Addressing Obesity and Weight Loss
Obesity Risks: Obesity is associated with higher perioperative complications.
Weight Loss Approaches: Diet restriction, physical activity, pharmacotherapy, and bariatric surgery are effective but require careful management to avoid nutritional deficits.
Key Recommendations
The review advocates for preoperative nutritional evaluation using laboratory tests, anthropometric measures, and screening tools.
It emphasizes the need for protein supplementation and recommends including vitamin D supplementation.
A holistic approach involving dieticians and personalized care plans is suggested for high-risk patients.
This study underscores the critical role of nutrition in orthopedic surgery, advocating for a more comprehensive approach to patient care and highlighting the need for ongoing research and innovation in this area.
