Abstract:
Objective To evaluate the value of perioperative nutritional support in the enhanced recovery of patients undergoing total knee replacement, and further explore its mechanism.
Methods This study retrospectively analyzed the data of patients undergoing unilateral total knee arthroplasty performed by the same senior surgeon for osteoarthritis in the second affiliated hospital of the army medical university from January 2017 to December 2018. Patients who did not receive perioperative refined nutrition intervention in 2017 were set as the routine nutrition group, and patients who formally received perioperative refined nutrition intervention in 2018 were observed as the refined nutrition group. The preoperative health economics variates, postoperative early inflammation and nutritional hematology index, postoperative 1 year joint function score, complications and other follow-up variables were analyzed and compared between the two groups.
Results Compared to the conventional nutrition group, the length of hospital stay and total length of stay in the refined nutrition group were significantly reduced by 1.16 days (20.24%, P<0.001) and 1.36 days (15.11%, P<0.001), respectively. Hospitalization expenses were also significantly reduced (55,00 RMB, 21.83%, P<0.001). CRP and other inflammatory indexes, as well as nutritional indexes such as albumin and prealbumin on the 3rd day after the operation, were significantly improved in the refined nutrition group, than those in the conventional nutrition group. Besides, there was an increase in the score of joint function in the refined nutrition group at clinic follow-up (1 year after surgery), but the result was not statistically significant. The overall incidence of postoperative incision complications, superficial infection, and deep vein thrombosis was significantly reduced by 16.7% (P=0.002).
Conclusion The perioperative refined nutrition support has a definite significance in promoting the enhanced recovery after artificial knee arthroplasty, by mechanisms of minimizing the inflammatory response of surgical trauma, reducing protein loss, and lowering the incidence of complications.
Key words:
Delicacy management,
Nutrition intervention,
Arthroplasty, replacement,
Enhanced recovery after surgery,
Inflammation
Maohong Dai, Zaiyang Liu, Jie Li, Kaiqi He, Jun Zhang, Chen Huang, Yumei Zhang, Yuan Zhang. The value and preliminary mechanism of perioperative nutritional support in the enhanced recovery after total knee arthroplasty[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2021, 07(05): 298-303.