Attenuation of Muscle Atrophy Through Amino Acid Supplementation in Patients Following Total Knee Arthroplasty
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Date
2016-06
Authors
Ralph, Max
Journal Title
Journal ISSN
Volume Title
Publisher
University of Oregon
Abstract
Background. Total knee arthroplasty (TKA) is becoming increasingly common
in the United States. Over 3.4 million older US adults are predicted to undergo primary
TKA annually by the year 2030, and over 4.5 million Americans already live with a
primary knee prosthesis. Immediately following surgery, significant muscle atrophy
occurs, compromising strength and functional mobility of the patient. Essential amino
acid supplementation has been proven to mitigate post-operative muscle atrophy in
TKA patients at the level of whole muscle, and this strategy has the potential to
attenuate individual muscle fiber atrophy as well. Metl,ods. Data collection for this
Honors Thesis is part of an ongoing double-blind, placebo-controlled randomized
clinical trial. This Honors Thesis will present blinded raw data from 14 patients who
have completed the study. Patients are randomized to ingest either 20 g of EAAs or
placebo twice daily between meals for 1 week before and for 6 weeks after TKA. At
baseline, 2 and 6 weeks post-TKA, an MRI was performed on each leg to measure
muscle mass over time. In addition, each subject had bi-lateral biopsies performed in
the operating room just prior to surgery and again at either 1 or 2 weeks post-TKA (random allocation within each cohort). Digital analysis methods were developed to
quantify muscle volume (MRI) and muscle cell cross-sectional area (histology) .
Results. This blinded study is not yet complete and therefore this Honors Thesis will
not report any results. The data reported are coded and randomized in order to maintain
the integrity of the clinical trial. Conclusion. Unfortunately, the effectiveness of
essential amino acid supplementation in attenuating muscle atrophy cannot be assessed
in this Honors Thesis. However, the precision of the analysis techniques developed here
can be evaluated and confirmed. Furthermore, the clinical importance of EAA
supplementation in potentially decreasing post-operative muscle atrophy in TKA
patients is substantiated as this surgery is becoming increasingly prominent in the US.
Description
47 pages. A thesis presented to the Department of Human Physiology and the Clark Honors College of the University of Oregon in partial fulfillment of the requirements for degree of Bachelor of Science, Spring 2016.
Keywords
Biology, Muscle Physiology, Skeletal Muscle, Muscle Atrophy, Total Knee Arthroplasty, Osteoarthritis, Sarcopenia