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Mga Suplementong Pangkalusugan ng Musculoskeletal

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Evidence on dietary supplements for joint, muscle and bone health — protein and amino acids, creatine, collagen peptides, glucosamine and chondroitin, and omega-3 — including perioperative recovery and osteoarthritis.

Updated Aug 2026
Isang kapsula ng suplemento sa tabi ng isang dahon.
Ang ilang suplemento ay sumusuporta sa kalusugan ng buto at kasu-kasuan, habang marami ang sobrang ibinebenta — nakakatulong ang pag-alamin kung alin sa mga ito ang may ebidensya. Kieran Hirpara 4.0

Ang pahinang ito ay isinalin ng makina at hindi pa nasusuri ng isang doktor. Ang bersyong Ingles ang siyang opisyal.

Ano ang nararamdaman mo

Maaaring mapansin mo ang pagkakasikip at sakit sa iyong mga kasukasuan, lalo na pagkatapos magpahinga o sa unang bahagi ng umaga. Ang arthritis na dulot ng pagkasira ay madalas na nagpapahirap sa mga pang-araw-araw na gawain. Maaaring mahirapan ka sa mga simpleng galaw tulad ng pag-abot sa likod upang isara ang bra o pagtupi ng iyong kamiseta. Maaaring lumala ang sakit pagkatapos ng aktibidad o kapag nakatulog ka sa gilid, na nagdudulot ng pagkagambala sa iyong pahinga.

Maaaring talakayin ng iyong doktor ang mga nutritional supplement upang matulungan ang pamamahala ng mga sintomas na ito. Ang glucosamine at chondroitin sulfate ay karaniwang mga pagpipilian. Mayroon itong mahusay na profile ng kaligtasan at maaaring maglingkod bilang paunang paggamot para sa maraming pasyente na may osteoarthritis. Sinusuportahan ng ebidensya ang glucosamine sulfate sa pagbabawas ng sakit at pagpapabuti ng function. Maaari rin nitong tulungan ang pag-regulate ng pinsala sa kasukasuan sa tuhod. Gayunpaman, ang mga hindi nasasagot na katanungan tungkol sa pangmatagalang epekto at dosage ang nagpipigil sa isang definitibong pagpapatibay. Mayroon ding kakulangan sa substansyal na ebidensya upang ganap na patibayin ang mga agent na ito para sa lahat.

Kung hindi hadlang ang gastusin, ang mga supplement na ito ay maaaring makatwirang mga pagpipilian bilang bahagi ng mas malawak na plano para sa symptomatic primary osteoarthritis ng kamay. Bukod dito, ang n-3 polyunsaturated fatty acids ay epektibo sa pagpapagaan ng sakit at pagpapabuti ng function ng kasukasuan sa mga pasyenteng may osteoarthritis. Para sa mga geriatric na pasyente na hindi makapag-ehersisyo, ang espesipikong nutritional supplementation lamang ay maaaring magbigay ng benepisyo.

Pagkatapos ng operasyon, tulad ng anterior cruciate ligament reconstruction, ang adjuvant oral supplementation na naglalaman ng collagen, hyaluronic acid, chondroitin sulfate, at plasma proteins ay maaaring dagdagan ang epektybidad ng physical therapy. Ang pamamaraang ito ay maaaring magpaikli ng oras na kailangan upang bumalik sa aktibidad bago ang pinsala at bawasan ang pangangailangan para sa gamot sa sakit. Ang intravenous protein o amino acid supplementation ay nag-aalok din ng mga benepisyo para sa mga pasyenteng nasa ilalim ng total joint replacement, bagaman ang mga epekto sa lakas ng kalamnan at function ay halo-halo.

Ang nutritional optimization ay nauugnay sa pagpapabuti ng mga resulta para sa mga pasyenteng nasa ilalim ng spine surgery. Ito ay malaki ang pagbaba sa mga gastusin sa ospital sa pamamagitan ng pagbaba ng mga rate ng pagpasok sa intensive care unit, mga komplikasyon na dulot ng ospital, at mga impeksyon na nakuha sa ospital. Ang supplementation ng conditionally essential amino acid ay may protektibong epekto laban sa mga karaniwang komplikasyon at maagang pagkasira ng kalamnan ng eskeleto pagkatapos ng operative fixation ng mga fracture sa extremity at pelvic.

Sa kabila ng mga benepisyong ito, ang mga substansyal na hadlang sa nutritional optimization sa spine surgery ay kinabibilangan ng hindi consistent na mga protocol at hindi pagsunod ng pasyente. Kailangan ang standardization ng multidisciplinary na mga nutritional protocol. Kailangan pa ng karagdagang imbestigasyon upang matukoy ang epektibong mga perioperative nutritional protocol para sa spine surgery. Ang iyong doktor ay tutulungan kang gabayan ang mga pagpipiliang ito batay sa iyong mga partikular na pangangailangan at mga gabay na base sa ebidensya.

Ano ang nangyayari talaga

Ang iyong mga kasukasuan ay dinisenyo upang gumalaw nang maayos. Ang cartilage ay nagsisilbing shock absorber sa pagitan ng iyong mga buto. Ito ang makinis na patong sa mga dulo ng buto na pumipigil sa alitan. Kapag nasira ang patong na ito, nararamdaman mo ang sakit at katigasan. Ang pagkasira at pagkasira ay karaniwan sa osteoarthritis. Sinusubukan ng iyong katawan na ayusin ang pinsala, ngunit madalas hindi niya kayang makasabay.

Ang mga nutritional supplement ay naglalayong suportahan ang proseso ng pag-aayos. Halimbawa, ang glucosamine at chondroitin sulfate ay maaaring tumulong sa pagpapanatili ng kalusugan ng cartilage. Mayroon silang mahusay na safety profile at mababang side effects. May ilang pasyente ang nakikita na binabawasan nito ang sakit at pinapabuti ang function. Gayunpaman, hindi sapat ang ebidensya upang garantisadong magbigay ng resulta para sa lahat. Hindi pa namin alam ang pinakamainam na long-term dosage para sa mga supplement na ito. Kaya, hindi namin maaaring definitibong ipagmalaki ang mga ito bilang gamot.

Ang iba pang supplement ay nakatuon sa pamamaga at kalusugan ng kalamnan. Ang N-3 polyunsaturated fatty acids ay maaaring magpahinga ng sakit at mapabuti ang function ng kasukasuan. Ang collagen at hyaluronic acid ay maaaring tumulong sa iyong katawan na gumaling nang mas mabilis pagkatapos ng operasyon. Maaari nitong maikli ang oras na kailangan upang bumalik sa iyong mga gawaing bago ang pinsala. Ito ay lalo pang makatulong kung ikaw ay nagpapagaling mula sa anterior cruciate ligament reconstruction.

Para sa mga matatanda o mga hindi makapag-ehersisyo, ang mga partikular na supplement ay maaaring magbigay ng direktang benepisyo. Ang intravenous protein o amino acids ay maaaring suportahan ang paggaling pagkatapos ng total joint replacement. Tumutulong ito upang labanan ang muscle wasting, na ang pagkawala ng muscle mass pagkatapos ng operasyon. Ang tamang nutrisyon ay nagbabawas din ng gastusin sa ospital sa pamamagitan ng pagbaba ng panganib ng mga komplikasyon at impeksyon.

Sa spine surgery, ang nutritional optimization ay nagpapabuti ng mga resulta. Gayunpaman, ang hindi consistent na mga protocol at hindi pagsunod ng pasyente ay nananatiling malaking hadlang. Patuloy pa rin naming iminumungkahi ang pinakamainam na mga protocol para sa mga spine patient. Sa ngayon, ang mga supplement ay isa sa bahagi ng mas malawak na plano. Pinakamainam silang gumagana kasama ang physical therapy at iba pang mga treatment. Ang iyong surgeon ay tutulong sa iyo upang desisyunin kung ang mga ito ay angkop para sa iyong partikular na sitwasyon.

Ano ang inaasahan

Ang mga suplementong pampagkain ay maaaring magkaroon ng makabuluhang papel sa iyong kalusugan ng muskulo-eskeletiko, bagaman magkakaiba ang mga resulta. Para sa mga matatanda na hindi makapag-ehersisyo, ang mga partikular na suplemento ay maaaring magbigay ng malinaw na benepisyo. Kung ikaw ay mayroong operasyon sa pagpapalit ng kasu-kasuan, ang intravenous na protina o mga amino acid ay maaaring tumulong sa iyong paggaling, kahit hindi garantisadong makakakuha ka ng pagtaas ng lakas ng kalamnan. Para sa pangkalahatang sakit ng kasu-kasuan, ang mga suplemento tulad ng glucosamine at chondroitin sulfate ay may napakahusay na profile ng kaligtasan. Maaari silang magsilbing unang hakbang sa pamamahala ng arthritis na dulot ng pagkasira. Maaaring makita mong binabawasan nila ang sakit at pinapabuti ang pagganap na may kaunting side effects. Gayunpaman, hindi pa namin lubos na nauunawaan ang kanilang mga epekto sa pangmatagalan o ang pinakamainam na mga dosis. Ang kakulangan sa katiyakan na ito ay nangangahulugan na hindi namin maaaring bigyan sila ng definitibong pagpapatibay para sa lahat.

Kung mayroon kang osteoarthritis sa iyong kamay, ang mga suplementong ito ay maaaring maging makatwirang bahagi ng iyong plano ng paggamot kung ang gastusin ay hindi hadlang. Para sa osteoarthritis sa tuhod, ang glucosamine sulfate ay maaaring tumulong sa pag-regulate ng pinsala sa kasu-kasuan at pagpapagaan ng sakit. Ang mga omega-3 fatty acids (n-3 polyunsaturated fatty acids) ay epektibo din sa pagpapagaan ng sakit at pagpapabuti ng pagganap ng kasu-kasuan. Pagkatapos ng rekonstruksyon ng ligamento sa tuhod, ang mga suplementong naglalaman ng collagen, hyaluronic acid, at iba pang protina ay maaaring tumulong sa iyong muling pagbabalik sa mga aktibidad bago ang pinsala nang mas mabilis. Maaari mo ring kailanganin ang mas kaunting mga gamot pang-alis ng sakit sa panahong ito.

Para sa mga pasyente sa operasyon sa gulugod, ang paghahanda ng iyong katawan na may tamang nutrisyon bago ang operasyon ay nauugnay sa mas magagandang resulta. Ito ay kilala bilang perioperative nutritional optimization. Tumutulong ito sa pagbawas ng mga gastusin sa ospital sa pamamagitan ng pagbaba ng panganib ng pagpasok sa intensive care at impeksyon. Gayunpaman, mahirap sundin ang mga planong nutrisyonal na ito dahil sa hindi magkakasamang mga gabay o mga isyu sa personal na pagsunod. Patuloy pa rin kaming nagsisiyasat sa pinakamainam na mga protokol para sa operasyon sa gulugod. Sa huli, habang ang mga suplemento ay maaaring sumuporta sa iyong paggaling at pagpapagaan ng sakit, sila ay gumagana nang pinakamainam bilang bahagi ng mas malawak na plano ng pag-aalaga na kasama ang physical therapy at propesyonal na gabay medikal.

Reviewed by Kieran Hirpara · 12 June 2026.

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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

  • Specific nutritional supplementation alone may benefit geriatric patients, particularly those unable to exercise [1].
  • Intravenous protein or amino acid supplementation offers benefits for patients undergoing total joint arthroplasty, although effects on muscle strength and function are mixed [2].
  • Glucosamine and chondroitin sulfate have an excellent safety profile [3].
  • Glucosamine and chondroitin sulfate may serve as an initial treatment modality for many osteoarthritis patients [3].
  • Adjuvant oral supplementation containing collagen, hyaluronic acid, chondroitin sulfate, and plasma proteins may increase the efficacy of physical therapy after anterior cruciate ligament reconstruction by shortening the time needed to return to pre-injury activity and reducing analgesic consumption [4].
  • Evidence supports the efficacy of glucosamine sulfate in reducing pain, improving function, and possibly regulating joint damage in knee osteoarthritis [5].
  • 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 [6].
  • The lack of substantial evidence currently prevents a ringing endorsement of glucosamine and chondroitin sulfate agents [6].
  • Nutritional supplementation markedly reduces hospital costs by reducing rates of ICU admissions, hospital-associated complications, and hospital-acquired infections in orthopaedic surgery [7].
  • If cost is not prohibitive, glucosamine and chondroitin sulfate products may be considered reasonable treatment options as part of a multimodal approach for symptomatic primary osteoarthritis of the hand [8].
  • Supplementation of n-3 polyunsaturated fatty acids is effective to relieve pain and improve joint function in patients with osteoarthritis [9].
  • 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 [10].
  • Perioperative nutritional optimization is associated with improved outcomes for patients undergoing spine surgery [23].
  • Additional investigation is needed to determine effective perioperative nutritional protocols for spine surgery [23].
  • Substantial barriers to nutritional optimization in spine surgery include inconsistent protocols and patient nonadherence, highlighting the need for multifactorial assessment and standardization of multidisciplinary nutritional protocols [17].

How It Works

  • Intravenous protein or amino acid supplementation offers benefits for total joint arthroplasty, although effects on muscle strength and function are mixed [2].
  • Glucosamine and chondroitin sulfate have an excellent safety profile and may serve as an initial treatment modality for many osteoarthritis patients [3].
  • 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 [4].
  • Glucosamine sulfate may have a synergic action with non-steroidal anti-inflammatory drugs for the treatment of knee osteoarthritis [5].
  • Evidence supports glucosamine sulfate efficacy in reducing pain, improving function, and possibly regulating joint damage in knee osteoarthritis [5].
  • Nutritional supplementation markedly reduces hospital costs by reducing rates of ICU admissions, hospital-associated complications, and hospital-acquired infections [7].
  • Glucosamine and chondroitin sulfate products may be considered reasonable treatment options as part of a multimodal approach for symptomatic primary osteoarthritis if the cost is not prohibitive [8].
  • Protein supplementation is a low-cost intervention that is easy to incorporate into perioperative management for total knee arthroplasty [11].
  • Protein supplementation has beneficial effects on muscle strength that could potentially reduce the risk of longer-term complications, such as falls and periprosthetic fracture, after total knee arthroplasty [11].
  • Integrating targeted nutrition into prehabilitation pathways may help reduce complications and support faster functional gains in total joint arthroplasty [12].
  • Omega-3 fatty acids protect cartilage from acute injuries by reducing the mechanical sensitivity of chondrocytes [13].
  • EPA supplementation could offer a promising strategy for preventing post-traumatic osteoarthritis progression following acute cartilage injuries [13].
  • Protein supplementation appears to have beneficial effects on mitigating muscle atrophy in the postoperative period following anterior cruciate ligament reconstruction, total hip arthroplasty, total knee arthroplasty, and surgical treatment of hip fracture [14].
  • An eight-week collagen-based supplement containing type I and type III collagen peptide and type II hydrolyzed collagen had a positive effect on pain and quality of life levels and some functional test results in patients with meniscopathy [16].

What the Evidence Shows

Osteoarthritis Management

  • Glucosamine sulfate has the potential to relieve pain and improve function with low side effects [6].
  • Unanswered questions regarding long-term effects and dosage of glucosamine sulfate preclude a definitive endorsement [6].
  • A lack of substantial evidence currently prevents a ringing endorsement of glucosamine and chondroitin agents [6].
  • If cost is not prohibitive, glucosamine and chondroitin products may be considered reasonable treatment options as part of a multimodal approach for symptomatic primary osteoarthritis [8].
  • Oral chondroitin is more effective than placebo on relieving pain and improving physical function in osteoarthritis [19].
  • Glucosamine showed an effect on stiffness outcomes in osteoarthritis [19].
  • Supplementation of n-3 polyunsaturated fatty acids (omega-3 PUFAs) is effective to relieve pain and improve joint function in patients with osteoarthritis [9].

Perioperative and Postoperative Supplementation

  • Specific nutritional supplementation alone might benefit geriatric patients, especially those unable to exercise [1].
  • While effects on muscle strength and function are mixed, intravenous protein or amino acid supplementation offers benefits in total joint arthroplasty [2].
  • 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 [10].
  • 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 [11].
  • 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].
  • Oral nutritional supplementation and dietetic assistance represent low-risk interventions that may improve morbidity and mortality in hip fracture aftercare for older people [15].
  • A comprehensive balanced nutrition supplement resulted in lower complication rates and mortality at 120 days postoperatively for hip fracture patients [20].

Specific Supplement Efficacy and Limitations

  • 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].
  • Patients do not benefit from creatine supplementation during the first 12 weeks of rehabilitation after anterior cruciate ligament reconstruction [21].

Practical Considerations

  • Adjuvant oral supplementation containing collagen, hyaluronic acid, chondroitin sulfate, and plasma proteins may increase the efficacy of physical therapy after anterior cruciate ligament reconstruction by shortening the time to return to pre-injury activity [4].
  • Adjuvant oral supplementation containing collagen, hyaluronic acid, chondroitin sulfate, and plasma proteins may reduce analgesic consumption after anterior cruciate ligament reconstruction [4].
  • Evidence supports the efficacy of glucosamine sulfate in reducing pain and improving function in knee osteoarthritis [5].
  • Glucosamine sulfate may possibly regulate joint damage in knee osteoarthritis [5].
  • Glucosamine sulfate has potential to relieve pain and improve function with low side effects in osteoarthritis [6].
  • Lack of substantial evidence currently prevents a ringing endorsement of glucosamine and chondroitin sulfate agents [6].
  • If cost is not prohibitive, glucosamine and chondroitin sulfate may be considered reasonable treatment options as part of a multimodal approach for symptomatic primary osteoarthritis of the hand [8].
  • Protein supplementation after total knee arthroplasty has beneficial effects on muscle strength [11].
  • Beneficial effects of protein supplementation on muscle strength after total knee arthroplasty could potentially reduce the risk of longer-term complications such as falls and periprosthetic fracture [11].
  • Oral nutritional supplementation and dietetic assistance represent low-risk interventions that may improve morbidity and mortality in older people after hip fracture [15].
  • Substantial barriers to nutritional optimization in spine surgery include inconsistent protocols and patient nonadherence [17].
  • Standardization of multidisciplinary nutritional protocols is needed in spine surgery [17].
  • Use of low-cost commercially available amino acid supplementation resulted in fewer overall complications postoperatively [18].
  • Amino acid supplementation is a low-risk intervention for the patient population studied [18].

Key Evidence

  • [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. [1] (10.1016/j.jamda.2015.05.021)
  • [L1] While effects on muscle strength and function are mixed, intravenous supplementation offers benefits. [2] (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. [3] (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. [4] (10.1177/2325967118s00040)
  • [L4] The evidence supports efficacy in reducing pain, improving function, and possibly regulating joint damage. [5] (10.1186/s12891-022-06046-6)
  • [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. [6] (10.5435/00124635-200109000-00009)
  • [L4] Nutritional supplementation has been shown to markedly reduce hospital costs by reducing rates of ICU admissions, hospital-associated complications, and hospital-acquired infections. [7] (10.5435/jaaos-d-23-00300)
  • [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. [8] (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. [9] (10.1186/s13018-023-03855-w)
  • [L1] CEAA supplementation has a protective effect against common complications and early skeletal muscle wasting after operative fixation of extremity and pelvic fractures. [10] (10.2106/jbjs.21.01014)
  • [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. [11] (10.2106/jbjs.22.01357)
  • [L4] Integrating targeted nutrition into prehabilitation pathways may help reduce complications and support faster functional gains. [12] (10.1016/j.arth.2026.03.088)
  • [L5] The findings suggest that EPA supplementation could offer a promising strategy for preventing PTOA progression following acute cartilage injuries. [13] (10.1186/s13018-024-05081-4)
  • [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] Despite these benefits, substantial barriers like inconsistent protocols and patient nonadherence remain, highlighting the need for multifactorial assessment and standardization of multidisciplinary nutritional protocols. [17] (10.5435/jaaos-d-25-00757)
  • [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. [18] (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. [19] (10.1186/s13018-018-0871-5)
  • [L1] The comprehensive balanced nutrition supplement resulted in lower complication rates and mortality at 120 days postoperatively. [20] (10.1097/01.blo.0000224054.86625.06)
  • [L1] The results demonstrate that patients do not benefit from creatine supplementation during the first 12 weeks of rehabilitation after ACL reconstruction. [21] (10.1177/0363546503261731)
  • [L4] Perioperative nutritional optimization has been associated with improved outcomes for patients undergoing spine surgery, but additional investigation is needed to determine effective perioperative nutritional protocols. [23] (10.5435/jaaos-d-24-01101)

References

[1] 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

[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] 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

[4] 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

[5] 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

[6] 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

[7] 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

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

[9] 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

[10] 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

[11] 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

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

[13] 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

[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] Nutritional Optimization in Spine Surgery: A Review of Its Implications for Postoperative Recovery and Outcomes. Journal of the American Academy of Orthopaedic Surgeons. 2026. DOI: 10.5435/jaaos-d-25-00757

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

[19] 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

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

[21] 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

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

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Considerations for the public: By using one of our public licenses, a licensor grants the public permission to use the licensed material under specified terms and conditions. If the licensor's permission is not necessary for any reason--for example, because of any applicable exception or limitation to copyright--then that use is not regulated by the license. Our licenses grant only permissions under copyright and certain other rights that a licensor has authority to grant. Use of the licensed material may still be restricted for other reasons, including because others have copyright or other rights in the material. A licensor may make special requests, such as asking that all changes be marked or described. Although not required by our licenses, you are encouraged to respect those requests where reasonable. More considerations for the public: wiki.creativecommons.org/Considerations_for_licensees

Creative Commons Attribution-NonCommercial 4.0 International Public License

By exercising the Licensed Rights (defined below), You accept and agree to be bound by the terms and conditions of this Creative Commons Attribution-NonCommercial 4.0 International Public License ("Public License"). To the extent this Public License may be interpreted as a contract, You are granted the Licensed Rights in consideration of Your acceptance of these terms and conditions, and the Licensor grants You such rights in consideration of benefits the Licensor receives from making the Licensed Material available under these terms and conditions.

Section 1 -- Definitions.

a. Adapted Material means material subject to Copyright and Similar Rights that is derived from or based upon the Licensed Material and in which the Licensed Material is translated, altered, arranged, transformed, or otherwise modified in a manner requiring permission under the Copyright and Similar Rights held by the Licensor. For purposes of this Public License, where the Licensed Material is a musical work, performance, or sound recording, Adapted Material is always produced where the Licensed Material is synched in timed relation with a moving image.

b. Adapter's License means the license You apply to Your Copyright and Similar Rights in Your contributions to Adapted Material in accordance with the terms and conditions of this Public License.

c. Copyright and Similar Rights means copyright and/or similar rights closely related to copyright including, without limitation, performance, broadcast, sound recording, and Sui Generis Database Rights, without regard to how the rights are labeled or categorized. For purposes of this Public License, the rights specified in Section 2(b)(1)-(2) are not Copyright and Similar Rights.

d. Effective Technological Measures means those measures that, in the absence of proper authority, may not be circumvented under laws fulfilling obligations under Article 11 of the WIPO Copyright Treaty adopted on December 20, 1996, and/or similar international agreements.

e. Exceptions and Limitations means fair use, fair dealing, and/or any other exception or limitation to Copyright and Similar Rights that applies to Your use of the Licensed Material.

f. Licensed Material means the artistic or literary work, database, or other material to which the Licensor applied this Public License.

g. Licensed Rights means the rights granted to You subject to the terms and conditions of this Public License, which are limited to all Copyright and Similar Rights that apply to Your use of the Licensed Material and that the Licensor has authority to license.

h. Licensor means the individual(s) or entity(ies) granting rights under this Public License.

i. NonCommercial means not primarily intended for or directed towards commercial advantage or monetary compensation. For purposes of this Public License, the exchange of the Licensed Material for other material subject to Copyright and Similar Rights by digital file-sharing or similar means is NonCommercial provided there is no payment of monetary compensation in connection with the exchange.

j. Share means to provide material to the public by any means or process that requires permission under the Licensed Rights, such as reproduction, public display, public performance, distribution, dissemination, communication, or importation, and to make material available to the public including in ways that members of the public may access the material from a place and at a time individually chosen by them.

k. Sui Generis Database Rights means rights other than copyright resulting from Directive 96/9/EC of the European Parliament and of the Council of 11 March 1996 on the legal protection of databases, as amended and/or succeeded, as well as other essentially equivalent rights anywhere in the world.

l. You means the individual or entity exercising the Licensed Rights under this Public License. Your has a corresponding meaning.

Section 2 -- Scope.

a. License grant.

1. Subject to the terms and conditions of this Public License, the Licensor hereby grants You a worldwide, royalty-free, non-sublicensable, non-exclusive, irrevocable license to exercise the Licensed Rights in the Licensed Material to:

a. reproduce and Share the Licensed Material, in whole or in part, for NonCommercial purposes only; and

b. produce, reproduce, and Share Adapted Material for NonCommercial purposes only.

2. Exceptions and Limitations. For the avoidance of doubt, where Exceptions and Limitations apply to Your use, this Public License does not apply, and You do not need to comply with its terms and conditions.

3. Term. The term of this Public License is specified in Section 6(a).

4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a) (4) never produces Adapted Material.

5. Downstream recipients.

a. Offer from the Licensor -- Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.

b. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.

6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

b. Other rights.

1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.