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Nutritional Supplements for Musculoskeletal Health

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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 Sep 202625 citations
A supplement capsule beside a leaf.
Some supplements support bone and joint health while many are over-sold — it helps to know which have evidence. Kieran Hirpara 4.0

What it is

Nutritional supplements are products you take by mouth (or sometimes by drip before surgery) to support your muscles, joints and recovery. They include things like protein and amino acid powders, collagen, omega-3 fish oils, glucosamine and chondroitin, and vitamin D. They are not a replacement for standard orthopaedic care such as exercise, physiotherapy or surgery. Because the research on many of these products is still patchy, they are not currently recommended as a substitute for the care you would already receive [1].

People consider supplements in a few situations. If you are having a joint replacement or fracture surgery, extra protein or amino acids around the time of your operation may help protect your muscles while you recover [2] [3]. If you are older, or unable to exercise, specific supplements such as vitamin D with whey protein may help [4]. If you have wear-and-tear arthritis (osteoarthritis), glucosamine and chondroitin have a good safety record and are sometimes used as a first thing to try [5]. Omega-3 supplements taken for 3-4 months have been shown to reduce joint pain, morning stiffness and the need for anti-inflammatory tablets [6].

How they work is fairly simple. Protein and amino acids are the building blocks of muscle, so topping them up around surgery may slow muscle loss and speed early recovery [7]. Omega-3 fats may protect the lining of the joint by making it less sensitive to strain [8]. Glucosamine may help the joint produce more of its own natural lubricating fluid [9].

A few cautions. Not every supplement helps: creatine did not help people in the first 12 weeks of rehab after knee ligament reconstruction [10]. And if you compete in sport, some supplements can cause a positive drug test, so check anything you take [11].

Does it work?

The honest answer is that it depends on which supplement and what you are using it for. Some have solid research behind them, others do not.

Around the time of surgery, the evidence is fairly encouraging. Protein or amino acids given by drip before or after joint replacement can help [1]. A balanced nutritional supplement given to people with hip fractures led to fewer complications and fewer deaths in the 120 days after surgery [2]. A commercially available amino acid supplement led to fewer complications after surgery and was low risk for patients [3]. For spine surgery, better nutrition around the operation has been linked to improved outcomes, though the best way to do it is still being worked out [4]. Adding targeted nutrition to exercise programs before joint replacement may reduce complications and support faster functional gains [5].

For arthritis, some products show real but modest benefits. Glucosamine sulfate and anti-inflammatory tablets can reduce pain and improve function in knee osteoarthritis [6]. Chondroitin taken by mouth relieves pain and improves physical function better than a dummy tablet, while glucosamine helped with stiffness [7]. Collagen peptides reduced knee arthritis pain compared with a dummy tablet [8]. An eight-week collagen supplement improved pain and quality of life in people with torn meniscus cartilage [9].

Other areas are weaker or mixed. Effects of protein supplementation on muscle strength and function after joint replacement are mixed [1]. Creatine did not help people in the first 12 weeks of rehab after knee ligament reconstruction [10]. For rotator cuff tendinopathy (a worn or inflamed shoulder tendon), collagen injected near the tendon reduced pain and supported recovery, with effects lasting up to six months [11]. But this was an injection rather than a tablet, and the research base is small.

So supplements are not a magic fix. They seem most useful alongside, not instead of, the exercise, physiotherapy and surgery you would already receive.

What are the risks?

Most of these supplements have a low risk of harm, but low risk is not no risk, and the details matter.

For tablets and powders such as glucosamine and chondroitin, the research describes a good safety record [1]. Glucosamine sulfate has the potential to relieve pain and improve function with low side effects [2]. Even so, researchers have not settled every question: there are still unanswered questions about long-term effects and dosage [2]. If you compete in sport, the stakes can be higher than side effects. Some supplements can harm your health, your performance or your reputation if they cause a positive drug test [3].

Injected supplements carry different risks from swallowed ones. Collagen injected near the shoulder tendon reduced pain and supported recovery, with effects lasting up to six months [4]. But an injection is a procedure, not a tablet, and the research on it is small, so it is harder to say how often problems at the injection site occur.

Around surgery, the picture is mostly about what supplements can prevent rather than cause. A balanced nutritional supplement given to people with hip fractures led to fewer complications and fewer deaths in the 120 days after surgery [5]. Oral supplements and dietetic help are described as low-risk interventions for older people after hip fracture [6]. A commercially available amino acid supplement led to fewer complications after surgery and was low risk [7]. Protein supplements are easy to add to care around an operation, and their effects on muscle could lower the risk of longer-term problems such as falls and fracture near the new joint [8].

Two honest limits. Creatine did not help people in the first 12 weeks of rehab after knee ligament reconstruction, so taking it adds nothing there [9]. And for spine surgery, better nutrition around the operation has been linked to improved outcomes, but the best protocols are still being worked out, partly because patients do not always stick to them [10] [11].

Is it right for you?

Supplements tend to suit people in a few situations. If you are older and have broken your hip, a balanced nutritional supplement around your operation may lower the chance of complications and death in the 120 days afterwards [1]. Oral supplements and dietetic help are low-risk options for older people after hip fracture [2]. If you are an older adult losing muscle and you cannot exercise, specific supplements may still help on their own [3]. If you have wear-and-tear arthritis in your hand, glucosamine and chondroitin can be reasonable to try as one part of a broader treatment plan [4].

They will probably not suit you if you expect them to replace the main treatments. Exercise, physiotherapy and surgery do the heavy lifting. Supplements work alongside those, not instead of them. Compared with those options, supplements are a smaller, supporting step rather than the main event.

There are also practical barriers. In spine surgery, getting nutrition right is hard because protocols vary and patients do not always stick to the plan [5]. That means you need a clear plan and honest follow-through for supplements to have a chance of helping.

The best way to decide is together with your doctor. Bring up what you want to achieve, whether that is less pain, stronger muscles or smoother recovery after surgery. Your doctor can weigh your health, your medications and the risks covered in the section above, then tell you whether a supplement fits your situation. If it does not, you have lost nothing by asking.

The bottom line

Supplements can be worth considering as a small, supporting step alongside your main treatment, not instead of it. Around surgery and after hip fracture, the research shows fewer complications and better recovery when nutrition is added to standard care [1] [2]. For arthritis, some products such as glucosamine, chondroitin and collagen can ease pain and improve function, though the benefits are modest [3] [4] [5]. Expect gradual, realistic change rather than a cure. The most important caveat: exercise, physiotherapy and surgery do the heavy lifting, so talk with your doctor before spending money or time on any supplement.

Reviewed by Kieran Hirpara · 12 June 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

References
  1. Peptide Supplements and Their Therapeutic Applications in Sports Medicine. *The American Journal of Sports Medicine*. 2026. 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. 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. 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. 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. 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. 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. 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. 10.1186/s13018-024-05081-4
  9. Glucosamine increases hyaluronic acid production in human osteoarthritic synovium explants. *BMC Musculoskeletal Disorders*. 2008. 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. 10.1177/0363546503261731
  11. IOC consensus statement: dietary supplements and the high-performance athlete. *British Journal of Sports Medicine*. 2018. 10.1136/bjsports-2018-099027
  12. Nutritional Supplementation Decreases Hip Fracture-related Complications. *Clinical Orthopaedics and Related Research*. 2006. 10.1097/01.blo.0000224054.86625.06
  13. Essential Amino Acid Supplementation: Feed the Injured Patient. *Journal of Bone and Joint Surgery*. 2022. 10.2106/jbjs.22.00078
  14. Perioperative Nutritional Optimization in Spine Surgery. *Journal of the American Academy of Orthopaedic Surgeons*. 2025. 10.5435/jaaos-d-24-01101
  15. Perioperative Nutritional Optimization in Total Joint Arthroplasty: From Screening to Supplementation. *The Journal of Arthroplasty*. 2026. 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. 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. 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. 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. 10.1186/s12891-024-08244-w
  20. Subacromial injection of hydrolyzed collagen in the symptomatic treatment of rotator cuff tendinopathy: an observational multicentric prospective study on 71 patients. *JSES International*. 2023. 10.1016/j.jseint.2023.06.009
  21. Use of Glucosamine and Chondroitin Sulfate in the Management of Osteoarthritis. *Journal of the American Academy of Orthopaedic Surgeons*. 2001. 10.5435/00124635-200109000-00009
  22. Cochrane in CORR®: Nutritional Supplementation for Hip Fracture Aftercare in Older People. *Clinical Orthopaedics & Related Research*. 2019. 10.1097/corr.0000000000000658
  23. Nutritional Optimization with Amino Acid Supplementation Aids Recovery After Total Knee Arthroplasty. *Journal of Bone and Joint Surgery*. 2023. 10.2106/jbjs.22.01357
  24. Nutritional Optimization in Spine Surgery: A Review of Its Implications for Postoperative Recovery and Outcomes. *Journal of the American Academy of Orthopaedic Surgeons*. 2026. 10.5435/jaaos-d-25-00757
  25. Glucosamine and Chondroitin Sulfate Treatment of Hand Osteoarthritis. *The Journal of Hand Surgery*. 2013. 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

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Using Creative Commons Public Licenses

Creative Commons public licenses provide a standard set of terms and conditions that creators and other rights holders may use to share original works of authorship and other material subject to copyright and certain other rights specified in the public license below. The following considerations are for informational purposes only, are not exhaustive, and do not form part of our licenses.

Considerations for licensors: Our public licenses are intended for use by those authorized to give the public permission to use material in ways otherwise restricted by copyright and certain other rights. Our licenses are irrevocable. Licensors should read and understand the terms and conditions of the license they choose before applying it. Licensors should also secure all rights necessary before applying our licenses so that the public can reuse the material as expected. Licensors should clearly mark any material not subject to the license. This includes other CC- licensed material, or material used under an exception or limitation to copyright. More considerations for licensors: wiki.creativecommons.org/Considerations_for_licensors

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.