If you are undergoing joint replacement surgery, it’s important to recognise the key role you can play in helping to determine the outcomes of your operation.
As orthopaedic surgeons, we ensure that we are up to date with the latest techniques and technologies to deliver the best possible results, but patients are sometimes surprised that they, too, have a role to play – and it’s an important one.
How nutrition affects surgical outcomes
A research study published in The Journal of Arthroplasty in November 2019 looked at how malnutrition affects outcomes ninety days after total joint replacement surgery. If someone is malnourished it means they are not getting sufficient nutrients (proteins, carbohydrates, fats, vitamins and minerals). This is normally due to deficiencies in diet although there are certain medical problems such as malabsorption syndromes that can cause malnutrition. Being malnourished can have a detrimental impact on recovery from surgery and may increase the risk of complications.
Indicator of malnutrition
For the 2019 study carried out by the Department of Orthopaedic Surgery at Duke University Medical Center, patient information was reviewed between 2013 and 2018 for pre-operative levels of albumin. Albumin is a protein made by your liver. It carries substances throughout your body including vitamins, enzymes and hormones, and helps prevent fluid from your bloodstream leaking into other tissues. Low albumin levels are a possible indicator of malnutrition.
Researchers found that 3.6% of patients surveyed had malnutrition. These patients were likely to experience a longer average length of stay in hospital and higher rates of readmission or visits to A&E. Low levels of albumin were also linked to patients being discharged to some kind of skilled nursing facility or rehabilitation unit, suggesting an increased likelihood of post-surgical complications, such as wound infections or being slow to heal.
Another study published in the same journal in January 2019, showed a clear link between malnutrition and post-operative wound infection.
What to do prior to surgery
If you are scheduled to undergo joint replacement surgery in the next few months, by making some simple changes to your diet now you can help yourself have the best possible recovery. We recommend eating a healthy balanced diet rich in vitamins and nutrients. Sometimes taking supplements can help if you are unable to get all of the vitamins you need from food. Vitamin C and zinc can help to maintain an efficient immune system, which is crucial for wound healing and fighting against infection. There is some evidence, too, that vitamin C may help prevent inflammation and joint damage.
Vitamin D is essential for healthy bones as it helps to increase bone density and promote the absorption of calcium. We mostly get Vitamin D from exposure to sunlight although you can also get it from oily fish, dairy products or by taking a supplement. Vitamin E is believed to be important for wound healing but you should avoid taking Vitamin E supplements for at least two weeks before surgery as it can increase the risk of bleeding.
Immediately after surgery your orthopaedic surgeon may advise avoiding foods that have high levels of Vitamin K, particularly if you are taking blood thinners. These include foods such as broccoli, cauliflower, Brussels sprouts, kale and green beans. It is important that you always follow your surgeon’s advice as she or he knows you best and can recommend what is best for you.
Here at Carrothers Orthopaedics, we take a holistic approach so all our patients receive detailed pre-operative and post-operative advice to help them achieve the best outcomes. If you are interested in discussing joint replacement surgery, contact us for advice, information and support.
Talk to an orthopaedic consultant | Cambridge
Please be reassured that despite the ongoing UK Covid-19 pandemic, types of orthopaedic treatments are now again being routinely offered to patients. Having the vaccine does not mean that your treatment won’t go ahead. However, in some circumstances, such as for planned surgery, it is advisable to delay it by a couple of weeks to ensure your body responds in the optimum way to the vaccine. If in doubt, please talk to your orthopaedic consultant or contact us for more guidance to help get your orthopaedic treatment back on track.
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