Dillan Mistry, Thomas I Gee and Paul Lee*
Background: Nutrition is increasingly becoming a greater part of medicine and in particular surgery. Pertinent nutritional clinical goals involve reducing recovery times by supplementing patients with additional nutrients and to prepare them for elective surgery so that recovery can be optimised. To assist in achieving the aforementioned outcomes within musculoskeletal surgery, supplementation with creatine and protein/Essential Amino Acids (EAA) can be a useful addition to patient care.
Methods: A systematic review was performed using EMBASE, Scopus and Medline as search engines. This yielded 200 articles of which nine were included within the analysis.
Findings: Two articles investigated creatine supplementation in orthopaedic knee surgery whilst seven focused on protein supplementation. Both creatine studies investigated pre and post-operative supplementation and found that creatine did not augment recovery of muscular strength. Whilst the six of the protein supplementation studies reported positive post-operative effects in respect to increases in strength and muscle mass. However no study matching the search criteria investigated the combination of both creatine and protein, likewise no study was found to report the speed of post-operative recovery with supplementation.
Conclusion: Supplementation with protein/EAA’s is beneficial for those in the post-operative period in helping to reduce muscle atrophy and improve wound healing. There is limited evidence regarding the effects of creatine supplementation within such clinical populations, however there is a very good safety profile for both protein/EAA and creatine highlighting that supplementation is safe and can be experimented with.
