Here we provide evidence-based information about how good nutrition can make a difference to the outcome of joint replacement surgery.
Impact of lockdown
Lockdown has been a challenge for many people on many different levels. One of these is the closure of gyms and swimming pools and the ‘stay at home’ message which has led inevitably to a more sedentary lifestyle for many. For some people the result has been weight gain and, if you are a sufferer of a degenerative condition like osteoarthritis, lack of exercise and increased pressure on joints due to excess weight may well have exacerbated your symptoms.
If you have severe arthritis and conservative treatments such as steroid injections or physiotherapy are no longer effective, your orthopaedic consultant may recommend joint replacement surgery. This involves removing some or all of your damaged joint and replacing it with a prosthetic implant.
Study into the link between good nutrition and positive surgical outcomes
Right now, you may face longer waits than normal due to the impact of the pandemic. Although this may be frustrating and inconvenient, particularly if you are in pain, it can be an opportunity to prepare yourself for surgery and to ensure the best possible outcomes. A recent study in The Journal of Arthroplasty looked at the link between nutrition and the success of a person’s joint replacement surgery.
Researchers from the Complex Joint Reconstruction Center Hospital for Special Surgery in New York carried out a review of studies that reported on outcomes for patients who were malnourished and had undergone a total hip or knee replacement (referred to as arthroplasty). Sadly, malnutrition continues to be quite common among the general population and various studies have shown a link between poor nutrition and poorer surgical outcomes. However, this was the first study of its kind to evaluate the link between nutrition and the outcomes of joint replacement.
Risk of complications
The researchers were particularly keen to find out if there was a higher chance of post-operative wound infection and other complications if a patient is malnourished. Some studies have shown that malnutrition can increase the length of time a patient needs to stay in hospital and even the patient’s risk of dying.
They evaluated 20 studies which considered a range of serological (the scientific study of blood serum) markers of malnutrition, including albumin, total lymphocyte count and transferrin. Ninety per cent (18 out of 20) studies found a link between at least one serological marker and poor post-operative outcomes. In particular, patients with a low albumin level were more likely to develop wound complications after surgery. The researchers concluded that there is strong evidence that malnutrition is linked to poorer outcomes following joint replacement surgery.
Importance of a healthy diet
The implication of this for patients due to undergo hip or knee replacement surgery is that it is important to eat healthily before your operation to increase your chances of making a good recovery. As surgeons we recommend eating a healthy balanced diet, rich in fresh fruit and vegetables, healthy wholegrains, protein and carbohydrates. Avoid eating too much red meat or processed meat and limit your sugar and alcohol intake.
Exercise for flexibility
It is also important to exercise both to increase joint flexibility and to maintain a healthy body weight. A physiotherapist may be able to recommend exercises you can do to strengthen your muscles and improve flexibility. Getting outside for a walk can be beneficial for your physical and your mental health, both of which can be affected by a degenerative condition like arthritis.
If you are scheduled to undergo joint replacement surgery, talk to your orthopaedic surgeon who will be able to offer individual advice to help you prepare and may be able to put you in touch with other health professionals, such as nutritionists, who can support you.