Journal article
Conditionally Essential Amino Acid Supplementation Reduces Postoperative Complications and Muscle Wasting After Fracture Fixation: A Randomized Controlled Trial
Journal of bone and joint surgery. American volume, Vol.104(9), pp.759-766
05/04/2022
DOI: 10.2106/JBJS.21.01014
PMID: 35286282
Abstract
Postoperative complications and substantial loss of physical function are common after musculoskeletal trauma. We conducted a prospective randomized controlled trial to assess the impact of conditionally essential amino acid (CEAA) supplementation on complications and skeletal muscle mass in adults after operative fixation of acute fractures.
Adults who sustained pelvic and extremity fractures that were indicated for operative fixation at a level-I trauma center were enrolled. The subjects were stratified based on injury characteristics (open fractures and/or polytrauma, fragility fractures, isolated injuries) and randomized to standard nutrition (control group) or oral CEAA supplementation twice daily for 2 weeks. Body composition (fat-free mass [FFM]) was measured at baseline and at 6 and 12 weeks postoperatively. Complications were prospectively collected. An intention-to-treat analysis was performed. The relative risk (RR) of complications for the control group relative to the CEAA group was determined, and linear mixed-effects models were used to model the relationship between CEAA supplementation and changes in FFM.
Four hundred subjects (control group: 200; CEAA group: 200) were enrolled. The CEAA group had significantly lower overall complications than the control group (30.5% vs. 43.8%; adjusted RR = 0.71; 95% confidence interval [CI] = 0.55 to 0.92; p = 0.008). The FFM decreased significantly at 6 weeks in the control subjects (-0.9 kg, p = 0.0205), whereas the FFM was maintained at 6 weeks in the CEAA subjects (-0.33 kg, p = 0.3606). This difference in FFM was not seen at subsequent time points.
Our results indicate that CEAA supplementation has a protective effect against common complications and early skeletal muscle wasting after operative fixation of extremity and pelvic fractures. Given the potential benefits of this inexpensive, low-risk intervention, multicenter prospective studies in focused trauma populations are warranted.
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Details
- Title: Subtitle
- Conditionally Essential Amino Acid Supplementation Reduces Postoperative Complications and Muscle Wasting After Fracture Fixation: A Randomized Controlled Trial
- Creators
- Nathan R Hendrickson - University of MinnesotaJohn Davison - University of IowaNatalie A Glass - University of IowaErin S Wilson - Department of Orthopedics & Rehabilitation, University of Iowa, Iowa City, IowaAspen Miller - University of IowaSteven Leary - University of IowaWilliam Lorentzen - University of IowaMatthew D Karam - Department of Orthopedics & Rehabilitation, University of Iowa, Iowa City, IowaMatthew Hogue - Department of Orthopedics & Rehabilitation, University of Iowa, Iowa City, IowaJ Lawrence Marsh - Department of Orthopedics & Rehabilitation, University of Iowa, Iowa City, IowaMichael C Willey - Department of Orthopedics & Rehabilitation, University of Iowa, Iowa City, Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of bone and joint surgery. American volume, Vol.104(9), pp.759-766
- DOI
- 10.2106/JBJS.21.01014
- PMID
- 35286282
- NLM abbreviation
- J Bone Joint Surg Am
- ISSN
- 0021-9355
- eISSN
- 1535-1386
- Publisher
- Journal of Bone and Joint Surgery Incorporated
- Language
- English
- Date published
- 05/04/2022
- Academic Unit
- Orthopedics and Rehabilitation; Surgery; Injury Prevention Research Center
- Record Identifier
- 9984304705302771
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