Mga Nutritional Supplement para sa Kalusugan ng Musculoskeletal Impormasyon

Ano ito

Ang mga nutritional supplement ay mga produktong iniinom (o kung minsan ay ibinibigay sa pamamagitan ng drip bago ang operasyon) upang suportahan ang iyong mga kalamnan, kasukasuan, at paggaling. Kasama rito ang mga bagay tulad ng protein at amino acid powders, collagen, omega-3 fish oils, glucosamine at chondroitin, at vitamin D. Hindi sila kapalit ng standard na orthopaedic care tulad ng ehersisyo, physiotherapy, o operasyon. Dahil ang pananaliksik sa marami sa mga produktong ito ay hindi pa kumpleto, sa kasalukuyan ay hindi sila inirerekomenda bilang kapalit ng pangangalagang natatanggap mo na [1].

Isinasaalang-alang ng mga tao ang mga supplement sa ilang sitwasyon. Kung ikaw ay sasailalim sa joint replacement o operasyon sa bali (fracture surgery), ang dagdag na protein o amino acids sa paligid ng oras ng iyong operasyon ay maaaring makatulong sa pagprotekta ng iyong mga kalamnan habang ikaw ay nagpapagaling [2] [3]. Kung ikaw ay matanda na, o hindi nakakapag-ehersisyo, ang mga partikular na supplement tulad ng vitamin D na may whey protein ay maaaring makatulong [4]. Kung ikaw ay may wear-and-tear arthritis (osteoarthritis), ang glucosamine at chondroitin ay may magandang safety record at kung minsan ay ginagamit bilang unang sinusubukan [5]. Ang mga omega-3 supplement na ininom sa loob ng 3-4 buwan ay napatunayang nakakabawas ng pananakit ng kasukasuan, paninigas sa umaga, at ang pangangailangan para sa mga anti-inflammatory tablet [6].

Ang paraan kung paano sila gumagana ay medyo simple. Ang protein at amino acids ang mga building block ng kalamnan, kaya ang pagdagdag sa mga ito sa paligid ng operasyon ay maaaring magpabagal sa pagkawala ng kalamnan at magpabilis sa maagang paggaling [7]. Ang mga omega-3 fat ay maaaring protektahan ang lining ng kasukasuan sa pamamagitan ng paggawa rito na hindi gaanong sensitibo sa strain [8]. Ang glucosamine ay maaaring makatulong sa kasukasuan na makagawa ng higit pa sa sarili nitong natural na lubricating fluid [9].

Ilang mga babala. Hindi lahat ng supplement ay nakakatulong: ang creatine ay hindi nakatulong sa mga tao sa unang 12 linggo ng rehab pagkatapos ng knee ligament reconstruction [10]. At kung ikaw ay nakikipagkumpitensya sa sports, ang ilang supplement ay maaaring magdulot ng positive drug test, kaya suriin ang anumang iyong iniinom [11].

Gumagana ba ito?

Ang tapat na sagot ay depende kung aling supplement at para saan mo ito ginagamit. Ang ilan ay may matibay na pananaliksik sa likod nito, ang iba naman ay wala.

Sa panahon ng operasyon, ang mga ebidensya ay medyo nakaka-encourage. Ang protein o amino acids na ibinibigay sa pamamagitan ng drip bago o pagkatapos ng joint replacement ay maaaring makatulong [1]. Ang isang balanced nutritional supplement na ibinigay sa mga taong may hip fractures ay humantong sa mas kaunting komplikasyon at mas kaunting pagkamatay sa loob ng 120 araw pagkatapos ng operasyon [2]. Ang isang commercially available na amino acid supplement ay humantong sa mas kaunting komplikasyon pagkatapos ng operasyon at may mababang panganib para sa mga pasyente [3]. Para sa spine surgery, ang mas mabuting nutrisyon sa paligid ng operasyon ay naiugnay sa pinabuting mga outcome, bagaman ang pinakamahusay na paraan ng paggawa nito ay pinag-aaralan pa rin [4]. Ang pagdaragdag ng targeted nutrition sa mga exercise program bago ang joint replacement ay maaaring magbawas ng mga komplikasyon at sumuporta sa mas mabilis na functional gains [5].

Para sa arthritis, ang ilang mga produkto ay nagpapakita ng tunay ngunit katamtamang mga benepisyo. Ang glucosamine sulfate at mga anti-inflammatory tablet ay maaaring magbawas ng sakit at magpahusay ng function sa knee osteoarthritis [6]. Ang chondroitin na iniinom ay nagpapaginhawa ng sakit at nagpapahusay ng physical function nang mas mabuti kaysa sa isang dummy tablet, habang ang glucosamine naman ay nakatulong sa paninigas [7]. Ang collagen peptides ay nagbawas ng sakit sa knee arthritis kumpara sa isang dummy tablet [8]. Ang walong linggong collagen supplement ay nagpahusay sa sakit at kalidad ng buhay sa mga taong may torn meniscus cartilage [9].

Ang ibang mga bahagi ay mas mahina o magkahalo. Ang mga epekto ng protein supplementation sa lakas at function ng kalamnan pagkatapos ng joint replacement ay magkahalo [1]. Ang creatine ay hindi nakatulong sa mga tao sa unang 12 linggo ng rehab pagkatapos ng knee ligament reconstruction [10]. Para sa rotator cuff tendinopathy (isang gasgas o namamagang tendon sa balikat), ang collagen na itinurok malapit sa tendon ay nagbawas ng sakit at sumuporta sa recovery, na may mga epektong tumatagal hanggang anim na buwan [11]. Ngunit ito ay isang injection sa halip na tablet, at maliit lamang ang basehan ng pananaliksik.

Kaya ang mga supplement ay hindi isang magic fix. Tila pinaka-kapaki-pakinabang ang mga ito kasabay ng, at hindi kapalit ng, exercise, physiotherapy at operasyon na matatanggap mo na.

Ano ang mga panganib?

Karamihan sa mga supplement na ito ay may mababang panganib ng pinsala, ngunit ang mababang panganib ay hindi nangangahulugang walang panganib, at mahalaga ang mga detalye.

Para sa mga tablet at powder tulad ng glucosamine at chondroitin, inilalarawan ng pananaliksik ang isang mabuting record ng kaligtasan [1]. Ang glucosamine sulfate ay may potensyal na maginhawa ng sakit at mapabuti ang function na may mababang side effects [2]. Gayunpaman, hindi pa nasasagot ng mga mananaliksik ang lahat ng katanungan: mayroon pa ring mga hindi nasasagot na katanungan tungkol sa mga long-term effect at dosage [2]. Kung ikaw ay nakikipagkompetisyon sa sport, maaaring mas mataas ang nakataya kaysa sa mga side effect. Ang ilang mga supplement ay maaaring makapinsala sa iyong kalusugan, sa iyong performance o sa iyong reputasyon kung magdudulot ang mga ito ng positive drug test [3].

Ang mga injected supplement ay may iba't ibang panganib kumpara sa mga nilulunok. Ang collagen na itinurok malapit sa tendon ng balikat ay nagbawas ng sakit at sumuporta sa recovery, na may mga epektong tumatagal hanggang anim na buwan [4]. Ngunit ang injection ay isang procedure, hindi isang tablet, at maliit lamang ang pananaliksik tungkol dito, kaya mas mahirap sabihin kung gaano kadalas nangyayari ang mga problema sa injection site.

Pagdating sa operasyon, ang sitwasyon ay higit na tungkol sa kung ano ang maaaring maiwasan ng mga supplement kaysa sa kung ano ang maaari nitong idulot. Ang isang balanced nutritional supplement na ibinigay sa mga taong may hip fracture ay humantong sa mas kaunting komplikasyon at mas kaunting pagkamatay sa loob ng 120 araw pagkatapos ng operasyon [5]. Ang mga oral supplement at dietetic help ay inilalarawan bilang mga low-risk intervention para sa mga nakatatanda pagkatapos ng hip fracture [6]. Ang isang commercially available na amino acid supplement ay humantong sa mas kaunting komplikasyon pagkatapos ng operasyon at may mababang panganib [7]. Ang mga protein supplement ay madaling idagdag sa pangangalaga sa paligid ng isang operasyon, at ang kanilang mga epekto sa kalamnan ay maaaring magpababa ng panganib ng mga long-term problem tulad ng pagkahulog at fracture malapit sa bagong joint [8].

Dalawang tapat na limitasyon. Ang Creatine ay hindi nakatulong sa mga tao sa unang 12 linggo ng rehab pagkatapos ng knee ligament reconstruction, kaya ang pag-inom nito ay walang naidaragdag doon [9]. At para sa spine surgery, ang mas mabuting nutrisyon sa paligid ng operasyon ay naiugnay sa pinabuting outcomes, ngunit ang mga pinakamahusay na protocol ay ginagawa pa rin, bahagya dahil ang mga pasyente ay hindi laging sumusunod sa mga ito [10] [11].

Tama ba ito para sa iyo?

Ang mga supplement ay may tendensiyang angkop sa mga tao sa ilang mga sitwasyon. Kung ikaw ay matanda na at nabali ang iyong balakang, ang isang balanseng nutritional supplement sa paligid ng iyong operasyon ay maaaring magpababa ng pagkakataon ng mga komplikasyon at kamatayan sa loob ng 120 araw pagkatapos nito [1]. Ang mga oral supplement at tulong sa diyeta ay mga low-risk na opsyon para sa mga matatanda pagkatapos ng hip fracture [2]. Kung ikaw ay isang nakatatandang adult na nawawalan ng kalamnan at hindi ka makapag-ehersisyo, ang mga partikular na supplement ay maaaring makatulong pa rin nang mag-isa [3]. Kung ikaw ay may wear-and-tear arthritis sa iyong kamay, ang glucosamine at chondroitin ay maaaring makatwirang subukan bilang isang bahagi ng isang mas malawak na plano ng paggamot [4].

Malamang na hindi ito angkop sa iyo kung inaasahan mong papalitan ng mga ito ang mga pangunahing paggamot. Ang ehersisyo, physiotherapy at surgery ang gumagawa ng mabibigat na trabaho. Ang mga supplement ay gumagana kasabay ng mga ito, hindi bilang kapalit. Kumpara sa mga opsyon na iyon, ang mga supplement ay isang mas maliit at sumusuportang hakbang sa halip na ang pangunahing solusyon.

Mayroon ding mga praktikal na hadlang. Sa spine surgery, mahirap makuha ang tamang nutrisyon dahil nag-iiba-iba ang mga protocol at ang mga pasyente ay hindi laging sumusunod sa plano [5]. Nangangahulugan ito na kailangan mo ng isang malinaw na plano at tapat na pagsunod upang ang mga supplement ay magkaroon ng pagkakataong makatulong.

Ang pinakamahusay na paraan upang magpasya ay kasama ang iyong doktor. Banggitin ang gusto mong makamit, ito man ay mas kaunting sakit, mas malakas na mga kalamnan o mas maayos na paggaling pagkatapos ng surgery. Maaaring timbangin ng iyong doktor ang iyong kalusugan, ang iyong mga gamot at ang mga panganib na tinalakay sa seksyon sa itaas, pagkatapos ay sasabihin sa iyo kung ang isang supplement ay angkop sa iyong sitwasyon. Kung hindi, wala ka namang nawala sa pagtatanong.

Ang pinaka-punto

Ang mga supplement ay maaaring isaalang-alang bilang isang maliit at sumusuportang hakbang kasabay ng iyong pangunahing gamutan, hindi bilang kapalit nito. Sa paligid ng operasyon at pagkatapos ng hip fracture, ipinapakita ng pananaliksik na mas kakaunti ang mga komplikasyon at mas mabuti ang paggaling kapag idinagdag ang nutrisyon sa standard care [1] [2]. Para sa arthritis, ang ilang mga produkto tulad ng glucosamine, chondroitin at collagen ay maaaring magpagaan ng sakit at magpahusay ng function, bagaman ang mga benepisyo ay katamtaman lamang [3] [4] [5]. Asahan ang unti-unti at makatotohanang pagbabago sa halip na isang lunas. Ang pinakamahalagang babala: ang ehersisyo, physiotherapy at operasyon ang gumagawa ng mabibigat na trabaho, kaya kumonsulta muna sa iyong doktor bago gumastos ng pera o oras sa anumang supplement.

Mga Sanggunian

[1] Peptide Supplements and Their Therapeutic Applications in Sports Medicine. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465261464420

[2] Peri-operative protein or amino acid supplementation for total joint arthroplasty: a systematic review and meta-analysis. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-05847-4

[3] Poster 363: Post-Operative Protein Supplementation following Orthopaedic Surgery: A Systematic Review. Orthopaedic Journal of Sports Medicine. 2023. DOI: 10.1177/2325967123s00326

[4] Effects of a Vitamin D and Leucine-Enriched Whey Protein Nutritional Supplement on Measures of Sarcopenia in Older Adults, the PROVIDE Study: A Randomized, Double-Blind, Placebo-Controlled Trial. Journal of the American Medical Directors Association. 2015. DOI: 10.1016/j.jamda.2015.05.021

[5] A Review of Evidence‐Based Medicine for Glucosamine and Chondroitin Sulfate Use in Knee Osteoarthritis. Arthroscopy. 2008. DOI: 10.1016/j.arthro.2008.07.020

[6] A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain. Pain. 2007. DOI: 10.1016/j.pain.2007.01.020

[7] 2020 Chitranjan S. Ranawat Award: Perioperative essential amino acid supplementation suppresses rectus femoris muscle atrophy and accelerates early functional recovery following total knee arthroplasty. The Bone & Joint Journal. 2020. DOI: 10.1302/0301-620x.102b6.bjj-2019-1370.r1

[8] Omega-3 fatty acids protect cartilage from acute injurie by reducing the mechanical sensitivity of chondrocytes. Journal of Orthopaedic Surgery and Research. 2024. DOI: 10.1186/s13018-024-05081-4

[9] Glucosamine increases hyaluronic acid production in human osteoarthritic synovium explants. BMC Musculoskeletal Disorders. 2008. DOI: 10.1186/1471-2474-9-120

[10] The Effect of Creatine Supplementation on Strength Recovery after Anterior Cruciate Ligament (ACL) Reconstruction. The American Journal of Sports Medicine. 2004. DOI: 10.1177/0363546503261731

[11] IOC consensus statement: dietary supplements and the high-performance athlete. British Journal of Sports Medicine. 2018. DOI: 10.1136/bjsports-2018-099027

[12] Nutritional Supplementation Decreases Hip Fracture-related Complications. Clinical Orthopaedics and Related Research. 2006. DOI: 10.1097/01.blo.0000224054.86625.06

[13] Essential Amino Acid Supplementation: Feed the Injured Patient. Journal of Bone and Joint Surgery. 2022. DOI: 10.2106/jbjs.22.00078

[14] Perioperative Nutritional Optimization in Spine Surgery. Journal of the American Academy of Orthopaedic Surgeons. 2025. DOI: 10.5435/jaaos-d-24-01101

[15] Perioperative Nutritional Optimization in Total Joint Arthroplasty: From Screening to Supplementation. The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2026.03.088

[16] Possible synergic action of non-steroidal anti-inflammatory drugs and glucosamine sulfate for the treatment of knee osteoarthritis: a scoping review. BMC Musculoskeletal Disorders. 2022. DOI: 10.1186/s12891-022-06046-6

[17] Effectiveness and safety of glucosamine and chondroitin for the treatment of osteoarthritis: a meta-analysis of randomized controlled trials. Journal of Orthopaedic Surgery and Research. 2018. DOI: 10.1186/s13018-018-0871-5

[18] Analgesic efficacy of collagen peptide in knee osteoarthritis: a meta-analysis of randomized controlled trials. Journal of Orthopaedic Surgery and Research. 2023. DOI: 10.1186/s13018-023-04182-w

[19] The effect of supplementation with type I and type III collagen peptide and type II hydrolyzed collagen on pain, quality of life and physical function in patients with meniscopathy: a randomized, double-blind, placebo-controlled study. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-024-08244-w

[20] Subacromial injection ng hydrolyzed collagen sa symptomatic treatment ng rotator cuff tendinopathy: isang observational multicentric prospective study sa 71 pasyente. JSES International. 2023. DOI: 10.1016/j.jseint.2023.06.009

[21] Paggamit ng Glucosamine at Chondroitin Sulfate sa Pamamahala ng Osteoarthritis. Journal of the American Academy of Orthopaedic Surgeons. 2001. DOI: 10.5435/00124635-200109000-00009

[22] Cochrane in CORR®: Nutritional Supplementation para sa Hip Fracture Aftercare sa mga Nakatatanda. Clinical Orthopaedics & Related Research. 2019. DOI: 10.1097/corr.0000000000000658

[23] Ang Nutritional Optimization gamit ang Amino Acid Supplementation ay Nakatutulong sa Recovery Pagkatapos ng Total Knee Arthroplasty. Journal of Bone and Joint Surgery. 2023. DOI: 10.2106/jbjs.22.01357

[24] Nutritional Optimization sa Spine Surgery: Isang Review ng mga Implikasyon nito para sa Postoperative Recovery at Outcomes. Journal of the American Academy of Orthopaedic Surgeons. 2026. DOI: 10.5435/jaaos-d-25-00757

[25] Glucosamine at Chondroitin Sulfate Treatment ng Hand Osteoarthritis. The Journal of Hand Surgery. 2013. DOI: 10.1016/j.jhsa.2013.05.017

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

Peptide supplements should not currently be recommended as a replacement or adjunct for existing orthopaedic standard of care due to the lack of robust efficacy and safety data [1].
Specific nutritional supplementation alone might benefit geriatric patients, especially those who are unable to exercise [2].
Intravenous protein or amino acid supplementation offers benefits for total joint arthroplasty, while effects on muscle strength and function are mixed [3].
The excellent safety profile of glucosamine and chondroitin sulfate should be discussed with patients [4].
Glucosamine and chondroitin sulfate may serve a role as an initial treatment modality for many osteoarthritis patients [4].
Adjuvant oral supplementation containing collagen, hyaluronic acid, chondroitin sulfate, and plasma proteins may increase the efficacy of physical therapy after anterior cruciate ligament reconstruction [5].
Adjuvant oral supplementation may shorten the time needed to return to pre-injury activity after anterior cruciate ligament reconstruction [5].
Adjuvant oral supplementation may reduce analgesic consumption after anterior cruciate ligament reconstruction [5].
Glucosamine sulfate has the potential to relieve pain and improve function with low side effects [7].
Unanswered questions regarding long-term effects and dosage preclude a definitive endorsement of glucosamine sulfate [7].
The lack of substantial evidence currently prevents a ringing endorsement of glucosamine and chondroitin sulfate [7].
The appropriate use of some dietary supplements can benefit the athlete [8].
Some dietary supplements may harm the athlete’s health, performance, and/or livelihood and reputation if an antidoping rule violation results [8].
Glucosamine and chondroitin sulfate may be considered reasonable treatment options as part of a multimodal approach for symptomatic primary hand osteoarthritis if the cost is not prohibitive [10].
Recommendations for data capture relating to female athlete population characteristics, injuries, illnesses, and other health consequences will improve the quality of epidemiological studies [18].
Improved quality of epidemiological studies will inform better injury and illness prevention strategies [18].

How It Works

Protein and Amino Acids

Adjuvant oral supplementation containing collagen, hyaluronic acid, chondroitin sulfate, and plasma proteins may increase the efficacy of physical therapy by shortening the time needed to return to pre-injury activity and reducing analgesic consumption after ACL reconstruction [5].
Protein supplementation is a low-cost intervention that is easy to incorporate into perioperative management for total knee arthroplasty [9].
Beneficial effects of protein supplementation on muscle strength could potentially reduce the risk of longer-term complications, such as falls and periprosthetic fracture, after total knee arthroplasty [9].
Conditionally essential amino acid (CEAA) supplementation has a protective effect against common complications and early skeletal muscle wasting after operative fixation of extremity and pelvic fractures [13].
Protein supplementation appears to have beneficial effects on mitigating muscle atrophy in the postoperative period following ACL reconstruction, total hip arthroplasty, total knee arthroplasty, and surgical treatment of hip fracture [14].
With protein supplementation, protein intakes at amounts greater than ~1.6 g/kg/day do not further contribute to resistance training-induced gains in fat-free mass in healthy adults [21].

Omega-3 Polyunsaturated Fatty Acids

Supplementation with omega-3 polyunsaturated fatty acids (PUFAs) for 3-4 months reduces patient-reported joint pain intensity, minutes of morning stiffness, number of painful and/or tender joints, and NSAID consumption [6].
Supplementation of n-3 PUFAs is effective to relieve pain and improve joint function in patients with osteoarthritis [11].
EPA supplementation could offer a promising strategy for preventing post-traumatic osteoarthritis (PTOA) progression following acute cartilage injuries [19].

Glucosamine and Chondroitin Sulfate

The excellent safety profile of glucosamine and chondroitin sulfate should be discussed with patients, and they may serve a role as an initial treatment modality for many osteoarthritis patients [4].
Glucosamine sulfate has potential to relieve pain and improve function with low side effects, but unanswered questions regarding long-term effects and dosage preclude a definitive endorsement [7].
The lack of substantial evidence currently prevents a ringing endorsement of glucosamine and chondroitin sulfate agents [7].
Evidence supports the efficacy of non-steroidal anti-inflammatory drugs and glucosamine sulfate in reducing pain, improving function, and possibly regulating joint damage in knee osteoarthritis [12].

Collagen

An eight-week collagen-based supplement had a positive effect on pain and quality of life levels and some functional test results in patients with meniscopathy [16].

General Considerations

Because of the lack of robust efficacy and safety data, peptide supplements should not currently be recommended as a replacement or adjunct for existing orthopaedic standard of care [1].
The appropriate use of some supplements can benefit the athlete, but others may harm the athlete’s health, performance, and/or livelihood and reputation if an antidoping rule violation results [8].

What the Evidence Shows

Perioperative and Postoperative Supplementation

Conditionally essential amino acid supplementation has a protective effect against common complications and early skeletal muscle wasting after operative fixation of extremity and pelvic fractures [13].
Oral nutritional supplementation and dietetic assistance represent low-risk interventions that may improve morbidity and mortality for hip fracture aftercare in older people [15].
A comprehensive balanced nutrition supplement resulted in lower complication rates and mortality at 120 days postoperatively for hip fracture patients [25].
Integrating targeted nutrition into prehabilitation pathways may help reduce complications and support faster functional gains in total joint arthroplasty [24].
Literature supports the clinical efficacy of essential amino acid supplementation in mitigating sarcopenia due to immobility and immobilization and improving functional recovery postoperatively [17].

Osteoarthritis and Joint Pain

Oral chondroitin is more effective than placebo on relieving pain and improving physical function, while glucosamine showed effect on stiffness outcome in osteoarthritis [23].
If the cost is not prohibitive, glucosamine and chondroitin sulfate products may be considered reasonable treatment options as part of a multimodal approach for symptomatic primary hand osteoarthritis [10].
Supplementation with omega-3 polyunsaturated fatty acids for 3-4 months reduces patient reported joint pain intensity, minutes of morning stiffness, number of painful and/or tender joints, and NSAID consumption [6].
Supplementation of n-3 polyunsaturated fatty acids is effective to relieve pain and improve joint function in patients with osteoarthritis [11].

Musculoskeletal Recovery and Sarcopenia

Specific nutritional supplementation alone might benefit geriatric patients, especially those who are unable to exercise, as shown by a vitamin D and leucine-enriched whey protein study [2].
Adjuvant oral supplementation containing collagen, hyaluronic acid, chondroitin sulfate, and plasma proteins may increase the efficacy of physical therapy by shortening the time needed to return to pre-injury activity and reducing analgesic consumption after anterior cruciate ligament reconstruction [5].

Peptide Supplements

Practical Considerations

Perioperative and Post-Operative Management

The beneficial effects of protein supplementation on muscle strength could potentially reduce the risk of longer-term complications, such as falls and periprosthetic fracture [9].
The use of low-cost commercially available amino acid supplements resulted in fewer overall complications postoperatively and was a low-risk intervention for the patient population [22].
Nutrition consultation and perioperative supplementation with amino acids and micronutrients are two readily available interventions that orthopaedic surgeons can select for malnourished patients [20].

Geriatric and Sarcopenia Considerations

Oral nutritional supplementation and dietetic assistance represent low-risk interventions that may improve morbidity and mortality in older people after hip fracture [15].

Osteoarthritis Management

Pain Management

General Guidelines and Contraindications

Key Evidence

[L5] Because of the lack of robust efficacy and safety data, peptide supplements should not currently be recommended as a replacement or adjunct for existing orthopaedic standard of care. [1] (10.1177/03635465261464420)
[L1] This study shows proof-of-principle that specific nutritional supplementation alone might benefit geriatric patients, especially relevant for those who are unable to exercise. [2] (10.1016/j.jamda.2015.05.021)
[L1] While effects on muscle strength and function are mixed, intravenous supplementation offers benefits. [3] (10.1186/s13018-025-05847-4)
[L2] The excellent safety profile of these supplements should be discussed with patients, and they may serve a role as an initial treatment modality for many OA patients. [4] (10.1016/j.arthro.2008.07.020)
[L1] Adjuvant oral supplementation may increase the efficacy of physical therapy by shortening the time needed to return to pre-injury activity and the analgesic consumption. [5] (10.1177/2325967118s00040)
[L1] Supplementation with omega-3 PUFAs for 3-4 months reduces patient reported joint pain intensity, minutes of morning stiffness, number of painful and/or tender joints, and NSAID consumption. [6] (10.1016/j.pain.2007.01.020)
[L5] The authors conclude that while glucosamine sulfate has potential to relieve pain and improve function with low side effects, unanswered questions regarding long-term effects and dosage preclude a definitive endorsement, and the lack of substantial evidence currently prevents a ringing endorsement of these agents. [7] (10.5435/00124635-200109000-00009)
[Paper] The appropriate use of some supplements can benefit the athlete, but others may harm the athlete’s health, performance, and/or livelihood and reputation (if an antidoping rule violation results). [8] (10.1136/bjsports-2018-099027)
[L5] Protein supplementation is a low-cost intervention that is easy to incorporate into perioperative management, and the beneficial effects on muscle strength could potentially reduce the risk of longer-term complications, such as falls and periprosthetic fracture. [9] (10.2106/jbjs.22.01357)
[L4] If the cost is not prohibitive, these products may be considered reasonable treatment options as part of a multimodal approach for symptomatic primary osteoarthritis. [10] (10.1016/j.jhsa.2013.05.017)
[L1] Supplementation of n-3 PUFAs is effective to relieve pain and improve joint function in patients with OA. [11] (10.1186/s13018-023-03855-w)
[L4] The evidence supports efficacy in reducing pain, improving function, and possibly regulating joint damage. [12] (10.1186/s12891-022-06046-6)
[L1] CEAA supplementation has a protective effect against common complications and early skeletal muscle wasting after operative fixation of extremity and pelvic fractures. [13] (10.2106/jbjs.21.01014)
[L1] Protein supplementation appears to have beneficial effects on mitigating muscle atrophy in the postoperative period following ACLR, THA, TKA, and surgical treatment of hip fracture. [14] (10.1177/2325967123s00326)
[L1] However, oral nutritional supplementation and dietetic assistance represent low-risk interventions that may improve morbidity and mortality. [15] (10.1097/corr.0000000000000658)
[L1] The results of the study showed that the eight-week collagen-based supplement had a positive effect on pain and quality of life levels and some functional test results in patients with meniscopathy. [16] (10.1186/s12891-024-08244-w)
[L4] Literature supports the clinical efficacy of essential amino acid supplementation in mitigating sarcopenia due to immobility and immobilization and improving functional recovery postoperatively. [17] (10.5435/jaaos-d-23-00300)
[L5] Our recommendations for data capture relating to female athlete population characteristics, and injuries, illnesses and other health consequences, will improve the quality of epidemiological studies, to inform better injury and illness prevention strategies. [18] (10.1136/bjsports-2022-106620)
[L5] The findings suggest that EPA supplementation could offer a promising strategy for preventing PTOA progression following acute cartilage injuries. [19] (10.1186/s13018-024-05081-4)
[L5] Nutrition consultation and perioperative supplementation with amino acids and micronutrients are 2 readily available interventions that orthopaedic surgeons can select for malnourished patients. [20] (10.2106/jbjs.rvw.23.00242)
[L1] With protein supplementation, protein intakes at amounts greater than ~1.6 g/kg/day do not further contribute RET-induced gains in FFM. [21] (10.1136/bjsports-2017-097608)
[L5] The use of the low-cost commercially available amino acid supplement resulted in fewer overall complications postoperatively and was a low-risk intervention for their patient population. [22] (10.2106/jbjs.22.00078)
[L1] Oral chondroitin is more effective than placebo on relieving pain and improving physical function, while glucosamine showed effect on stiffness outcome. [23] (10.1186/s13018-018-0871-5)
[L4] Integrating targeted nutrition into prehabilitation pathways may help reduce complications and support faster functional gains. [24] (10.1016/j.arth.2026.03.088)
[L1] The comprehensive balanced nutrition supplement resulted in lower complication rates and mortality at 120 days postoperatively. [25] (10.1097/01.blo.0000224054.86625.06)

References

[1] Peptide Supplements and Their Therapeutic Applications in Sports Medicine. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465261464420

[2] Effects of a Vitamin D and Leucine-Enriched Whey Protein Nutritional Supplement on Measures of Sarcopenia in Older Adults, the PROVIDE Study: A Randomized, Double-Blind, Placebo-Controlled Trial. Journal of the American Medical Directors Association. 2015. DOI: 10.1016/j.jamda.2015.05.021

[3] Peri-operative protein or amino acid supplementation for total joint arthroplasty: a systematic review and meta-analysis. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-05847-4

[4] A Review of Evidence‐Based Medicine for Glucosamine and Chondroitin Sulfate Use in Knee Osteoarthritis. Arthroscopy. 2008. DOI: 10.1016/j.arthro.2008.07.020

[5] Efficacy and Tolerability of a Dietary Supplement Containing Collagen, Hyaluronic Acid, Chondroitin Sulfate and Plasma Proteins in the Recovery After Anterior Cruciate Ligament Reconstruction. Orthopaedic Journal of Sports Medicine. 2018. DOI: 10.1177/2325967118s00040

[6] A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain. Pain. 2007. DOI: 10.1016/j.pain.2007.01.020

[7] Use of Glucosamine and Chondroitin Sulfate in the Management of Osteoarthritis. Journal of the American Academy of Orthopaedic Surgeons. 2001. DOI: 10.5435/00124635-200109000-00009

[8] IOC consensus statement: dietary supplements and the high-performance athlete. British Journal of Sports Medicine. 2018. DOI: 10.1136/bjsports-2018-099027

[9] Nutritional Optimization with Amino Acid Supplementation Aids Recovery After Total Knee Arthroplasty. Journal of Bone and Joint Surgery. 2023. DOI: 10.2106/jbjs.22.01357

[10] Glucosamine and Chondroitin Sulfate Treatment of Hand Osteoarthritis. The Journal of Hand Surgery. 2013. DOI: 10.1016/j.jhsa.2013.05.017

[11] Effect of omega-3 polyunsaturated fatty acids supplementation for patients with osteoarthritis: a meta-analysis. Journal of Orthopaedic Surgery and Research. 2023. DOI: 10.1186/s13018-023-03855-w

[12] Possible synergic action of non-steroidal anti-inflammatory drugs and glucosamine sulfate for the treatment of knee osteoarthritis: a scoping review. BMC Musculoskeletal Disorders. 2022. DOI: 10.1186/s12891-022-06046-6

[13] Conditionally Essential Amino Acid Supplementation Reduces Postoperative Complications and Muscle Wasting After Fracture Fixation. Journal of Bone and Joint Surgery. 2022. DOI: 10.2106/jbjs.21.01014

[14] Poster 363: Post-Operative Protein Supplementation following Orthopaedic Surgery: A Systematic Review. Orthopaedic Journal of Sports Medicine. 2023. DOI: 10.1177/2325967123s00326

[15] Cochrane in CORR®: Nutritional Supplementation for Hip Fracture Aftercare in Older People. Clinical Orthopaedics & Related Research. 2019. DOI: 10.1097/corr.0000000000000658

[16] The effect of supplementation with type I and type III collagen peptide and type II hydrolyzed collagen on pain, quality of life and physical function in patients with meniscopathy: a randomized, double-blind, placebo-controlled study. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-024-08244-w

[17] The Role of Amino Acid Supplementation in Orthopaedic Surgery. Journal of the American Academy of Orthopaedic Surgeons. 2023. DOI: 10.5435/jaaos-d-23-00300

[18] Female athlete health domains: a supplement to the International Olympic Committee consensus statement on methods for recording and reporting epidemiological data on injury and illness in sport. British Journal of Sports Medicine. 2023. DOI: 10.1136/bjsports-2022-106620

[19] Omega-3 fatty acids protect cartilage from acute injurie by reducing the mechanical sensitivity of chondrocytes. Journal of Orthopaedic Surgery and Research. 2024. DOI: 10.1186/s13018-024-05081-4

[20] The Role of Perioperative Nutritional Status and Supplementation in Orthopaedic Surgery. JBJS Reviews. 2024. DOI: 10.2106/jbjs.rvw.23.00242

[21] A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults. British Journal of Sports Medicine. 2017. DOI: 10.1136/bjsports-2017-097608

[22] Essential Amino Acid Supplementation: Feed the Injured Patient. Journal of Bone and Joint Surgery. 2022. DOI: 10.2106/jbjs.22.00078

[23] Effectiveness and safety of glucosamine and chondroitin for the treatment of osteoarthritis: a meta-analysis of randomized controlled trials. Journal of Orthopaedic Surgery and Research. 2018. DOI: 10.1186/s13018-018-0871-5

[24] Perioperative Nutritional Optimization in Total Joint Arthroplasty: From Screening to Supplementation. The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2026.03.088

[25] Nutritional Supplementation Decreases Hip Fracture-related Complications. Clinical Orthopaedics and Related Research. 2006. DOI: 10.1097/01.blo.0000224054.86625.06