Effects of supplementation with a combination of beta-hydroxy-beta-methyl butyrate, L-arginine, and L-glutamine on postoperative recovery of quadriceps muscle strength after total knee arthroplasty

• Published in: Asia Pacific journal of clinical nutrition Vol. 24; no. 3; pp. 412 - 420
• Main Authors: Nishizaki, Kanae, Ikegami, Hitoshi, Tanaka, Yukio, Imai, Ryutaro, Matsumura, Hajime
• Format: Journal Article
• Language: English
• Published: Clayton, Vic HEC Press 01.09.2015
• Subjects: Aged; Aged, 80 and over; Arginine - pharmacology; Arthroplasty, Replacement, Knee; Dietary Supplements; Drug Therapy, Combination; Exercise; Female; Glutamine - pharmacology; Humans; Male; Measurement; Muscle strength; Muscle Strength - drug effects; Osteoarthritis; Postoperative Care - methods; Postoperative Complications - prevention & control; Postoperative Period; Preoperative Care - methods; Quadriceps Muscle - drug effects; Testing; Total knee replacement; Treatment; Treatment Outcome; Valerates - pharmacology
• ISSN: 0964-7058
• DOI: 10.6133/apjcn.2015.24.3.01

Objectives: Total knee arthroplasty (TKA) performed in knee osteoarthritis patients is reported to be immediately followed by a decrease in quadriceps muscle strength. We investigated the effects of supplementation with a combination beta-hydroxy-beta-methyl butyrate, L-arginine, and L-glutamine (HMB/Arg/Gln) on the postoperative recovery of quadriceps muscle strength in patients after TKA. Methods: Study subjects were 23 patients (12 women; mean age: 70.5) who underwent TKA. The patients were randomly allocated into the control group or the group that consumed HMB/Arg/Gln supplementation (HMB/Arg/Gln group). HMB/Arg/Gln supplementation or control food were consumed for 5 days before the surgery and for 28 days after the surgery, and maximal quadriceps strength was measured at 7 days before the surgery, and at 14, 28 and 42 days after the surgery. During the study, total energy expenditure was measured using a lifestyle recording device. The two groups followed the rehabilitation in the same way. Results: The maximal quadriceps strength was 1.1+/-0.62 Nm/Kg before surgery and 0.7+/-0.9 Nm/Kg after surgery 14 days in the control group (p=0.02), and 1.1+/-0.3 Nm/Kg before surgery and 0.9+/-0.4 Nm/Kg after surgery 14 days in the HMB/Arg/Gln group. Although the control group experienced a significant loss of muscle strength after the surgery, the HMB/Arg/Gln group did not. There was no significant difference in total energy expenditure between the two groups. Conclusions: Consuming HMB/Arg/Gln supplementation may suppress the loss of muscle strength after TKA. Intervention with exercise and nutrition appears to enable patients to maintain their quadriceps strength.