What is the best way nutritionally to accelerate your recovery after surgery?

Essential Amino Acids (EAAs)

What are those?

Let’s start with a brief nutrition lesson. Protein is one of the three macronutrients that are needed in your diet (carbohydrates and fats are the other two). Protein is used for growth and development and to build and repair cells and body tissues. Protein is also the main component of all the muscles of your body.

All proteins are made of molecules called amino acids. These amino acids are divided into nonessential amino acids that do not need to be consumed in the diet and essential amino acids (EAAs) that must be obtained through your diet.

There are 8 EAAs and 3 of them – isoleucine, leucine, and valine – can be further identified as branched chain amino acids (BCAAs).

Why are these so important?

Research has identified the EAAs and BCAAs as the keys to stimulating protein synthesis. Protein synthesis leads to growth of skeletal muscles and repair of damaged cells and body tissues from surgery or injury.

How do you get EAAs in your diet?

You can obtain high levels of EAAs in two main ways. The easiest way is through nutritional supplements. You can also obtain EAAs through many types of animal-based proteins.

What does the research show?

There have been three randomized clinical trials that demonstrate the efficacy of EAAs supplementation for enhancing and accelerating recovery after joint replacement surgery. EAAs supplementation was found to be safe, reduces loss of muscle volume and strength following surgery, and improves function and mobility after surgery.
 

1. A 2013 randomized-controlled trial assessed older adults undergoing knee replacement surgery. One group received EAAs and one group received a placebo before and after surgery. The EAAs group had greater muscle volume and less muscle atrophy at 2 weeks and 6 weeks after surgery. The EAAs group also performed significantly better on all functional mobility tests after knee replacement surgery.
2. Another double-blind, placebo-controlled randomized trial was published in 2018 by Slocum Orthopedics and Oregon University. One group received EAA supplementation and one group received a placebo. The EAA group had significantly less decrease in quadriceps and hamstring muscle volume following knee replacement surgery.
3. Additionally, in 2018 the Hospital for Special Surgery provided a presentation to the American Academy of Orthopedic Surgeons regarding a clinical trial with EAA supplementation for knee replacement surgery. According to Dr. Mayman, who presented the study, ““Supplementation of amino acid prior to and for the first 2 weeks after surgery is a safe and easy way to improve patient recovery after surgery. It should be considered as part of your perioperative management in total knee replacement.”
4. A fourth study is currently being performed by the Slocum Foundation as part of the Slocum Center for Orthopedics and Sports Medicine to assess the benefits of an enhanced supplement formulation that includes increased amounts of the amino acid Leucine.

1. Dreyer, H. C., Strycker, L. A., Senesac, H. A., Hocker, A. D., Smolkowski, K., Shah, S. N., & Jewett, B. A. (2013). Essential amino acid supplementation in patients following total knee arthroplasty. The Journal of clinical investigation, 123(11).
2. Dreyer, H. C., Owen, E. C., Strycker, L. A., Smolkowski, K., Muyskens, J. B., Kirkpatrick, T. K., … & Mohler, C. G. (2018). Essential Amino Acid Supplementation Mitigates Muscle Atrophy After Total Knee Arthroplasty: A Randomized, Double-Blind, Placebo-Controlled Trial. JBJS Open Access, 3(2), 1-10.
3. Mayman, David and Jerabek, Seth. Essential Amino Acid Supplementation Associated with Improved TKA Recovery: https://www.hss.edu/newsroom_orthopedicstoday-aaos-drmayman.asp