As we rack up the years, our joints may suffer to the point that knee replacement surgery is recommended.
After a knee replacement surgery, it’s important to maintain your joint health. Getting the right nutrients, whether through your diet or supplements, may help.
New University of Oregon studies on protein intake in the Nov. 13 issue of the Journal of Clinical Investigation could spell relief and speed recovery for baby boomers who face total knee replacement. Twenty grams of essential amino acids taken twice daily for a week before and for two weeks after knee-replacement surgery helped patients recover faster and with much less muscle atrophy than a control group taking a placebo.
Nutritional supplements can influence outcomes for individuals undergoing major surgery, particularly in older persons whose functional reserve is limited. Accelerating recovery from total hip replacement (THR) and total knee replacement (TKR) may offer significant benefits. Therefore, we explored the role of nutritional supplements in improving recovery following THR and TKR.
A systematic review was conducted to source randomized clinical trials that tested nutritional supplements in cohorts of THR or TKR patients. Our search yielded nine relevant trials. Intake of a carbohydrate-containing fluid is reported to improve insulin-like growth factor levels, reduce hunger, nausea, and length of stay, and attenuate the decrease in whole-body insulin sensitivity and endogenous glucose release.
Amino acid supplementation is reported to reduce muscle atrophy and accelerate return of functional mobility. One paper reported a suppressive effect of beta-hydroxy beta-methylbutyrate, l-arginine, and l-glutamine supplementation on muscle strength loss following TKR.
There is limited evidence for nutritional supplementation in THR and TKR pathways; however, the low risk profile and potential benefits to adjunctive treatment methods, such as exercise programs, suggest nutritional supplements may have a role. Optimizing nutritional status pre-operatively may help manage the surgical stress response, with a particular benefit for undernourished, frail, or elderly individuals.
Eat These Foods Before Surgery
Food is pleasure. Food is fun. Food is fuel. What we eat on a day to day basis often becomes so intertwined with our habits, lifestyle and likes or dislikes that it becomes difficult to think of food as fuel. However, in the process of healing the body—whether it be from injury, arthritis or surgery—it’s important to think of food as more than just something you eat. Like medicine, food has very real healing properties that can make recovery faster, easier, and even safer.
When it comes to wound healing and the promotion of recovery, the body needs a surplus of protein. Amino acids are the fundamental make-up of protein and serve a wide array of bodily and structural functions. Proteins give us antibodies to keep our immune system in check and to regenerate tissue and heal wounds. Structurally, our body uses protein as building blocks for muscle, collagen, elastin, and keratin. Collagen is the main component in many tissues such as skin, tendon, muscle, ligaments, cartilage, blood vessels, bone and teeth.
Foods Naturally Rich in Protein
- A lot of recognized sources of protein are in animal products such as beef steak, ground beef, pork chops, chicken breast and eggs
- Tofu and soy
- Beans (black beans are low in sodium and saturated fat)
- Milk, cottage cheese and yogurt (especially greek).
- Seeds and nuts like almonds, walnuts, hemp hearts and peanut butter
- Protein-rich nutritional drinks or bars (we recommend Ensure and love Health Warrior Superfood protein bars which are low in sugar and vegetarian)
Calcium and Vitamin D
When you think of calcium think bone strength and repair. As the Wound Repair and Regeneration Journal cites, when it comes to wound repair “calcium is predominantly involved in the hemostatic phase (the stopping of bleeding),” but is also integral in “cell migration and regeneration patterns in later stages of healing”. Science Daily’s findings add to the healing powers of calcium, stating that it’s linked to “the very first step in repairing damaged tissue.”
In order to reap the rewards of bone health from calcium, you need supportive nutrients like vitamin D (or even vitamin K and Magnesium among others). Calcium and Vitamin D are like Sonny and Cher or peanut butter and jelly—they just go together and become a more powerful force when combined. Holistic nutritionist, Melissa McKeown illustrates, “Think of building bones like baking a cake. You can’t use just flour to make a cake. It needs other ingredients.” McMeowan explains, “if you try to build bone with calcium alone, calcium will end up storing itself in soft tissues such as the brain, heart, and blood vessels. Supportive nutrients put the calcium in its place and keep it there.”
Foods Rich in Both Calcium and Vitamin D
- Vitamin D fortified yogurt and cheese
- Whole grain fortified cereals
- Orange juice fortified with calcium and vitamin D
- Salmon, sardines or trout.
Vitamin C and Iron
Vitamin C is a vitamin that your body cannot make on it’s own. The only way to give your body access to this super-healing antioxidant is by way of consumption. Like protein, vitamin C is a requirement for the body to build or rebuild collagen. Healing in its most basic form is the rebuilding of collagen. Therefore, Vitamin C is needed to repair and grow tissue, and is used by the body to make skin, blood vessels, ligaments, bones, teeth and so forth.
In addition to being a standalone superhero, vitamin C enhances the absorption of its pal, iron. Vitamin C enhances the absorption of nonheme/plant-based iron by changing it into “ferric iron” which can be absorbed in the small intestine. Once properly absorbed, iron boosts pre-operative red blood cell levels, helps with the carrying of oxygen throughout the blood, offers immunity, and increases energy levels. The feeling of having more energy helps those injured or with decreased mobility exercise their way through key PreHab exercises that speeds up recovery.
After surgery, reaching the recommended iron level is linked to a reduced risk of postoperative anemia and blood transfusions.
Foods Rich in Vitamin C and Iron
- Vitamin C
- Citrus fruits
- Red fruits and vegetables like tomatoes or tomato juice, peppers and strawberries
- Green vegetables like spinach, broccoli, brussel sprouts and cabbage
- Red meat like liver, beef and lamb
- Seafoods like mussels or oysters
- Green vegetables like spinach, collard greens, swiss chard, peas and edamame
- Beans and lentils: kidney beans, pinto beans and garbanzo beans
- Seeds and nuts like walnuts, almonds, pistachios and sunflower seeds
- Blackstrap molasses
Other Vitamins, Nutrients and Healing Foods for Surgery
Zinc plays a role in improving immune function as well as cell regeneration and wound healing. Zinc is especially great when it comes to healing dermal tissue and skin. Foods high in zinc: cooked oysters contain more zinc than any food, followed by beef, lamb, toasted wheat germ, spinach, toasted pumpkin seeds, cashews, chocolate and so forth.
It’s been estimated that 75-80% of natural immunity resides in our gut. Probiotics are great for gut health and can counteract the effects of any post or pre-op antibiotics. Antibiotics kill bad bacteria, but they can also kill the good bacteria that live in our guts and aid in digestion. Foods high in probiotic: yogurt, fermented vinegars, sauerkraut, kimchee fermented beverages, kombucha.
“Bone broths are incredibly healing. They’re rich in vitamins and minerals in a simple, easy to digest form,” said McKeown. These broths contain collagen, gelatin, and glycine which collectively promote repair and healing, improve digestion and prevent muscle breakdown.
Foods To Eat After a Knee Replacement Surgery
- High-Quality Proteins: Eggs, poultry, fish, meat, and nuts are excellent sources of high-quality proteins that provide the building blocks which help the body repair itself and boost the body’s immunity.
- Complex Carbohydrates: As a result of the surgery your metabolism will be elevated which increases the body’s calorie requirements. But you must make sure your calories are obtained from complex carbohydrate such as whole grains, starchy vegetables, and legumes. Avoid simple carbohydrates found in foods such as pastries, desserts, cookies, candy, soda, and ice cream.
- Anti-Inflammatory Fats: Salmon, mackerel, sardines, and anchovies are good examples of fatty fish that contain high amounts of omega 3 fatty acids that have anti-inflammatory properties which reduces the inflammation in the body caused by the surgery.
- Calcium and Vitamin D: Calcium is key for maximizing bone and joint health especially when undergoing joint replacement surgery. Good sources of calcium include spinach, chia seeds, and kale as well as dairy products. Apart from eating calcium-rich foods, you need to spend at least 15-20 a day outdoors in the daytime so your body can synthesize vitamin D from sunlight which helps in the absorption of calcium from the food you eat.
- Vitamin C: This vitamin is essential for the formation of collagen which is present in the ligaments and tendons that connect the bones and muscles. Vitamin C rich foods include citrus fruits such as oranges, lemon, kiwi, and grapefruit; and vegetables such as cauliflower, capsicum, and Brussel sprouts.
Vitamin E for wound healing
Anecdotal reports claim that vitamin E — particularly vitamin E oil — can aid in wound healing and decrease scar formation.
Some doctors recommend applying the oil to your closed wound three times per day after removing your stitches.
However, researchers have not found evidence to support these claims, and some suggest vitamin E may worsen the appearance of scars. Scientists have called for more robust research.
Ask your doctor before using vitamin E. Taking Vitamin E orally should be avoided at least 2 weeks prior to surgery as it can increase the risk of bleeding according to the Mayo Clinic.
Consider herbal supplements
A variety of herbal supplements may help your body heal after a knee replacement surgery.
Green tea and rosehip tea have antioxidant properties and may promote wound healing.
Witch hazel or chickweed, applied topically, may reduce bruising after the incision has healed.
Echinacea and bromelain reduce inflammation and promote healing.
Arnica may reduce bruising.
Many of these supplements are said to reduce inflammation and swelling or fight infections and promote wound healing. However, there’s no conclusive evidence that these substances provide any benefit.
Consider non-herbal supplements
Other non-herbal supplements and substances may aid in healing, including fighting infection and rebuilding tissue.
- coenzyme Q10
- essential fatty acids
- free-form amino acids
- French maritime pine bark extract
Read more Knee Pain What You Should Know