Oral Nutritional Optimization in Total Joint Arthroplasty
Study Details
Study Description
Brief Summary
The purpose of this study is to determine the effect on hematological markers of nutritional intervention on nutritionally deficient patients following total joint replacement surgery.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Numerous pre-operative modifiable variables have been extensively investigated for their effect on outcomes in TJA. These include metabolic diseases such as diabetes mellitus, obesity, and smoking status. However, nutritional status has not been as thoroughly investigated; to date, no prospective randomized control study has assessed the effect of oral nutritional supplementation for malnourished patients. This study will be a novel investigation into the role for routine serum screening for malnutrition as well as oral nutritional supplementation in TJA patients. This study could serve as a stepping stone towards creating a new pathway to highlight at-risk patients and pre-operatively optimizing their outcomes after TJA.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Nutritional supplementation Given Ensure Max Protein Nutrition shake 2 weeks before surgery and continued 2 weeks after surgery. |
Dietary Supplement: Ensure
Ensure Max Protein Shake is an over the counter available drinkable nutritional supplement. Per serving, it contains:
160 Calories, 20 from fat
2g Total fat
0.5g Saturated fat
20mg Cholesterol
135mg Sodium
170mg Potassium
19g Total carbohydrate
<1g Fiber
4g Sugar
16g Protein
Participants will receive Ensure High Protein for 2 weeks pre- and 4 weeks post-operatively. These patients will be instructed to consume 1 serving (16fl oz) of Ensure High Protein daily. They will be provided with this product at a pre-operative clinical visit or have it mailed to their home. Hematologic nutritional values will be measured as specified previously.
Descriptive statistics will be used to report baseline characteristics and primary study objectives. Hematologic outcomes will be compared between the control ("NO ENSURE") and oral supplementation ("ENSURE") arms for the aforementioned baseline and perioperative variables
|
| No Intervention: No Nutritional supplementation Treatment as usual |
Outcome Measures
Primary Outcome Measures
- Changes in the patients' albumin, pre-albumin, and/or transferrin levels [Visit 2 (2 wks pre) Visit 3 (surgery day) Visit 5 (4 weeks post)]
Biological specimen collection and laboratory evaluations- all included patients' hematologic markers of malnutrition (albumin, pre-albumin, and transferrin) will be recorded at 2 weeks prior to surgery, the day of surgery, and 6 weeks. These blood tests can all be performed from one sample of blood at each visit. The results will then be accessed via the EMR
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Patient are current candidates for elective primary total hip and total knee arthroplasty
-
Patients ≥55 years of age but ≤ 95
-
Patients who meet at least one of the following three laboratory criteria for malnutrition:
TSerum Albumin: ≤3.5 mg/dl Pre-Albumin: <15 mg/dl Transferrin: <200 mg/dl
Exclusion Criteria:
-
Previous history of septic arthritis
-
Allergy to oral supplementation
-
Inability to consume oral supplementation
-
Protein malabsorption syndromes
-
Eating disorders
-
End stage renal and hepatic disease
-
Revision surgery, non-elective surgery, hemiarthroplasty, and unicompartmental knee arthroplasty
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | NYU Langone Health | New York | New York | United States | 10016 |
Sponsors and Collaborators
- NYU Langone Health
Investigators
- Principal Investigator: Ran Schwarzkopf, NYU Langone
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 18-01976