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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 Oct 202619 citations

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 extra nutrients you take by mouth, such as protein, amino acids, fish oil, collagen, or joint products like glucosamine and chondroitin. They are not medicines your doctor prescribes instead of surgery or physiotherapy. They sit alongside your usual care.

People consider them at different times. Some are used around joint replacement or fracture surgery to help your body cope with the stress of an operation. Others are tried for arthritis pain, or after injuries like a torn knee ligament. Athletes sometimes use them too, though some products can cause problems with anti-doping rules [1].

The thinking behind them is fairly simple. Your body needs building blocks to heal bone, muscle, and cartilage. Protein and amino acids are those building blocks for muscle. Omega-3 oils, found in fish, are thought to calm inflammation in joints. Glucosamine and chondroitin are substances your cartilage is made from, so supplementing them may support the joint surface.

The evidence varies a lot between products. Glucosamine and chondroitin have a good safety record and may be a reasonable early option for arthritis [2]. Omega-3 supplements taken for 3-4 months have been shown to reduce joint pain, morning stiffness, and the need for anti-inflammatory tablets [3]. Protein supplements around joint replacement or ligament surgery may help protect muscle while you recover [4]. Other products, such as peptide supplements, do not have enough good evidence yet to be recommended as part of standard orthopaedic care [5].

Your doctor can talk through which, if any, of these might suit your situation, and which are not worth your money or effort.

Does it work?

The honest answer is that it depends on which supplement and what you are recovering from. Some products have real evidence behind them. Others do not.

Protein supplements look the most promising around surgery. They may help protect your muscles while you recover from joint replacement, ligament reconstruction, or hip fracture surgery [4]. One review found that a low-cost amino acid supplement led to fewer complications after surgery [6]. For older people with hip fractures, balanced nutritional supplements were linked to fewer complications and fewer deaths in the first 120 days after surgery [7]. Nutrition advice combined with supplements may also help you get moving sooner after joint replacement [8].

For arthritis, the picture is more mixed. Glucosamine and chondroitin have a strong safety record and may ease pain and improve function, but questions remain about their long-term effects and the right dose [9]. Omega-3 oils taken for 3 to 4 months have been shown to reduce joint pain, morning stiffness, and the need for anti-inflammatory tablets [3]. Collagen peptides eased knee arthritis pain compared with a dummy supplement [10].

After ligament surgery, one study found that a supplement combining collagen, hyaluronic acid, chondroitin, and plasma proteins helped people return to their pre-injury activity sooner and take fewer painkillers [11]. But creatine showed no benefit in the first 12 weeks of rehabilitation after the same operation [12].

There are real gaps in the evidence. Many of these studies were small, and some findings are mixed. For example, protein given directly into a vein around joint replacement showed benefits, but its effects on muscle strength and function were inconsistent [13]. Research on amino acids marketed to boost athletic performance often fails to support those claims [14]. Spine surgery evidence is promising but incomplete, with more work needed to settle the best approach [15].

Your doctor can help you weigh up which supplements have solid evidence for your situation and which do not.

What are the risks?

For most of these supplements, the main risk is that they do not help. Creatine showed no benefit in the first 12 weeks of rehabilitation after knee ligament reconstruction [12]. Amino acids marketed to boost athletic performance often fail to live up to those claims in scientific research [14]. Peptide supplements do not have enough good evidence yet to be recommended as part of standard orthopaedic care [5].

Some products carry a different risk. Athletes need to be careful, because some supplements can harm your health or your performance, and some can cause an anti-doping rule violation that affects your reputation and livelihood [1].

There are also limits to what the evidence shows. Protein given directly into a vein around joint replacement offers some benefits, but its effects on muscle strength and function were inconsistent [13]. Glucosamine sulfate may ease pain and improve function with few side effects, but questions remain about its long-term effects and the right dose [9]. Calcium supplements looked like they helped broken bones heal in one study, but they did not improve bone strength in that same research [16].

On the other side of the ledger, some risks appear to be low. Glucosamine and chondroitin have a good safety record [2]. A low-cost amino acid supplement around surgery led to fewer complications and was described as a low-risk intervention [6]. For older people with hip fractures, oral nutritional supplements and dietetic help were also described as low-risk [17].

The honest summary is that the safety picture varies between products. Some have been studied carefully and appear to cause few problems. Others have gaps in the evidence, so their risks are less well understood. Your doctor can help you weigh up what is known about any product you are considering, including how it might interact with your other care.

Is it right for you?

Supplements may suit you if you are about to have joint replacement or fracture surgery, especially if your diet is lacking. Nutrition advice and supplements with amino acids and micronutrients are options your doctor can offer if you are malnourished [18]. For older people after a hip fracture, oral supplements and dietetic help may improve recovery and survival [17]. A balanced supplement was linked to fewer complications and fewer deaths in the first 120 days after hip fracture surgery [7].

If you have knee wear-and-tear arthritis, glucosamine sulfate may ease pain and improve how your joint works [19]. It may be worth trying before more involved treatments, since it has a good safety record.

Some people are less likely to benefit. If you eat well and have no surgery planned, extra protein or amino acids may add little. Calcium supplements looked like they helped broken bones heal, but did not improve bone strength in the same research [16]. If you are an athlete, check any product carefully, because some can breach anti-doping rules [1].

Compared with surgery or physiotherapy, supplements sit alongside your usual care rather than replacing it. They tend to work best when combined with good nutrition advice and a structured recovery plan.

This is a shared decision. Bring up any supplement you are considering with your doctor, along with your other medicines and health conditions. Together you can decide whether the evidence for that product matches your situation, or whether your effort is better spent elsewhere.

The bottom line

Supplements are worth considering in a few situations, mainly around surgery or for arthritis pain. Around joint replacement or hip fracture surgery, protein and balanced nutritional supplements are low-risk options that may mean fewer complications [6] [7]. For knee wear-and-tear arthritis, glucosamine sulfate may ease pain and improve function, with few side effects [9]. Expect modest gains, not dramatic ones, and know that some products, like creatine after ligament surgery, show no benefit at all [12]. The most important caveat: talk with your doctor before starting anything, because the evidence varies between products and some can clash with your other care or anti-doping rules.

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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. IOC consensus statement: dietary supplements and the high-performance athlete. *British Journal of Sports Medicine*. 2018. 10.1136/bjsports-2018-099027
2. A Review of Evidence‐Based Medicine for Glucosamine and Chondroitin Sulfate Use in Knee Osteoarthritis. *Arthroscopy*. 2008. 10.1016/j.arthro.2008.07.020
3. 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
4. Poster 363: Post-Operative Protein Supplementation following Orthopaedic Surgery: A Systematic Review. *Orthopaedic Journal of Sports Medicine*. 2023. 10.1177/2325967123s00326
5. Peptide Supplements and Their Therapeutic Applications in Sports Medicine. *The American Journal of Sports Medicine*. 2026. 10.1177/03635465261464420
6. Essential Amino Acid Supplementation: Feed the Injured Patient. *Journal of Bone and Joint Surgery*. 2022. 10.2106/jbjs.22.00078
7. Nutritional Supplementation Decreases Hip Fracture-related Complications. *Clinical Orthopaedics and Related Research*. 2006. 10.1097/01.blo.0000224054.86625.06
8. Perioperative Nutritional Optimization in Total Joint Arthroplasty: From Screening to Supplementation. *The Journal of Arthroplasty*. 2026. 10.1016/j.arth.2026.03.088
9. 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
10. 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
11. 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. 10.1177/2325967118s00040
12. The Effect of Creatine Supplementation on Strength Recovery after Anterior Cruciate Ligament (ACL) Reconstruction. *The American Journal of Sports Medicine*. 2004. 10.1177/0363546503261731
13. 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
14. FACTS AND FALLACIES OF PURPORTED ERGOGENIC AMINO ACID SUPPLEMENTS. *Clinics in Sports Medicine*. 1999. 10.1016/s0278-5919(05)70173-3
15. Perioperative Nutritional Optimization in Spine Surgery. *Journal of the American Academy of Orthopaedic Surgeons*. 2025. 10.5435/jaaos-d-24-01101
16. Effects of calcium supplements on fracture healing in a rat osteoporotic model. *Journal of Orthopaedic Research*. 2010. 10.1002/jor.21180
17. Cochrane in CORR®: Nutritional Supplementation for Hip Fracture Aftercare in Older People. *Clinical Orthopaedics & Related Research*. 2019. 10.1097/corr.0000000000000658
18. The Role of Perioperative Nutritional Status and Supplementation in Orthopaedic Surgery. *JBJS Reviews*. 2024. 10.2106/jbjs.rvw.23.00242
19. 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

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 peri-operative protein or amino acid supplementation offers benefits for total joint arthroplasty, while effects on muscle strength and function are mixed [3].
• Glucosamine and chondroitin sulfate have an excellent safety profile and 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 by shortening the time needed to return to pre-injury activity and reducing analgesic consumption [5].
• The 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 [7].
• 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 [8].
• 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 [9].
• The appropriate use of some dietary supplements can benefit the athlete, while others may harm the athlete’s health, performance, and/or livelihood and reputation if an antidoping rule violation results [12].
• Glucosamine sulfate has the potential to relieve pain and improve function with low side effects, but unanswered questions regarding long-term effects and dosage preclude a definitive endorsement [11].
• Nutritional supplementation has been shown to markedly reduce hospital costs by reducing rates of ICU admissions, hospital-associated complications, and hospital-acquired infections in orthopaedic surgery [14].
• 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 [15].
• 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 [32].

How It Works

Protein and Amino Acids

• Intravenous protein or amino acid supplementation offers benefits for total joint arthroplasty, while effects on muscle strength and function are mixed [3].
• 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 [9].
• Nutritional supplementation has been shown to markedly reduce hospital costs by reducing rates of ICU admissions, hospital-associated complications, and hospital-acquired infections [14].
• Protein supplementation is a low-cost intervention that is easy to incorporate into perioperative management [18].
• The beneficial effects of protein supplementation on muscle strength could potentially reduce the risk of longer-term complications, such as falls and periprosthetic fracture [18].
• 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 [21].
• Protein-containing nutrient supplementation immediately after single exercise sessions promotes the restoration of distal vasti muscle mass and knee extension muscle strength with resistance training in ACL patients [20].
• 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 [25].

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 the potential to relieve pain and improve function with low side effects [11].
• Unanswered questions regarding long-term effects and dosage preclude a definitive endorsement of glucosamine sulfate [11].
• The lack of substantial evidence currently prevents a ringing endorsement of glucosamine and chondroitin sulfate agents [11].
• 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 [7].
• 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 [15].
• High concentrations of glucosamine–chondroitin sulfate can alter the cyclic preload and acute overload responses of chondral explants [34].
• High concentrations of glucosamine–chondroitin sulfate have an effect on the mechanical properties in an in vitro model [34].
• Glucosamine sulfate restrains the TNFα-mediated up-regulation of MMP-3 in bovine nucleus pulposus intervertebral disc cells [39].
• Glucosamine provides a protective role against TNFα, an early mediator of disc degeneration [39].

Omega-3 Polyunsaturated Fatty Acids

• Supplementation with omega-3 PUFAs for 3-4 months reduces patient-reported joint pain intensity [8].
• Supplementation with omega-3 PUFAs for 3-4 months reduces minutes of morning stiffness [8].
• Supplementation with omega-3 PUFAs for 3-4 months reduces the number of painful and/or tender joints [8].
• Supplementation with omega-3 PUFAs for 3-4 months reduces NSAID consumption [8].
• Supplementation of n-3 PUFAs is effective to relieve pain and improve joint function in patients with osteoarthritis [19].
• EPA supplementation could offer a promising strategy for preventing post-traumatic osteoarthritis progression following acute cartilage injuries [35].

Collagen and Other Supplements

• 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 [5].
• Adjuvant oral supplementation containing collagen, hyaluronic acid, chondroitin sulfate, and plasma proteins may increase the efficacy of physical therapy by reducing analgesic consumption [5].
• An eight-week collagen-based supplement had a positive effect on pain levels in patients with meniscopathy [24].
• An eight-week collagen-based supplement had a positive effect on quality of life levels in patients with meniscopathy [24].
• An eight-week collagen-based supplement had a positive effect on some functional test results in patients with meniscopathy [24].
• Calcium supplements may appear to improve fracture healing of osteoporotic bone [16].
• Calcium supplements failed to improve strength in a rat osteoporotic model of fracture healing [16].
• Patients do not benefit from creatine supplementation during the first 12 weeks of rehabilitation after ACL reconstruction [28].
• Intra-articular injections of hyaluronic acid supplemented with CCL25 attenuate osteoarthritis in a guinea pig model [37].
• Supplementation with increasing concentrations of insulin-like growth factor-I enhances chondrocyte matrix synthesis [38].
• Supplementation with insulin-like growth factor-I may provide a means to enhance chondrocyte phenotypic stability and function during transplantation grafting procedures [38].
• The combination of anabolic growth factors and catabolic blockers improves the preservation of proteoglycan content of cartilage explants exposed to the depleting effects of IL-1 [40].

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 [12].
• Some supplements may harm the athlete’s health, performance, and/or livelihood and reputation if an antidoping rule violation results [12].

What the Evidence Shows

Perioperative and Postoperative Supplementation

• 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 [18].
• Nutrition consultation and perioperative supplementation with amino acids and micronutrients are 2 readily available interventions that orthopaedic surgeons can select for malnourished patients [22].
• Oral nutritional supplementation and dietetic assistance represent low-risk interventions that may improve morbidity and mortality in older people with hip fractures [23].
• 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 [26].
• Integrating targeted nutrition into prehabilitation pathways may help reduce complications and support faster functional gains in total joint arthroplasty [29].
• A comprehensive balanced nutrition supplement resulted in lower complication rates and mortality at 120 days postoperatively in patients with hip fractures [30].
• 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 [47].

Osteoarthritis and Joint Health

• 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 OA patients [4].
• The evidence supports efficacy in reducing pain, improving function, and possibly regulating joint damage when using non-steroidal anti-inflammatory drugs and glucosamine sulfate for knee osteoarthritis [7].
• 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 [11].
• Oral chondroitin is more effective than placebo on relieving pain and improving physical function, while glucosamine showed effect on stiffness outcome in osteoarthritis [43].
• 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 [8].
• Collagen peptides provide significant pain relief in patients with knee osteoarthritis compared to those who received placebo [45].

Musculoskeletal Injury and Rehabilitation

• 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 the analgesic consumption after ACL reconstruction [5].
• Restoration of the distal vasti muscle mass and knee extension muscle strength with resistance training is promoted further by protein-containing nutrient supplementation immediately after single exercise sessions in ACL patients [20].
• 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 [24].
• Bovine colostrum supplementation resulted in approximately 4 lower Oswestry Disability Index (ODI) scores than the control group over the 90-day study period, indicating improved physical function in adults with traumatic peri-trochanteric femoral fracture [46].

General Nutritional Principles and Specific Agents

• Specific nutritional supplementation alone might benefit geriatric patients, especially relevant for those who are unable to exercise [2].
• Calcium supplements may appear to improve fracture healing of osteoporotic bone but failed to improve strength in a rat osteoporotic model [16].
• With protein supplementation, protein intakes at amounts greater than ~1.6 g/kg/day do not further contribute resistance training-induced gains in fat-free mass in healthy adults [25].
• 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 [12].
• Peer-reviewed scientific research often fails to support the efficacy of amino acids marketed as ergogenics for enhancing athletic performance [49].

Practical Considerations

Perioperative and Postoperative Supplementation

• Protein supplementation is a low-cost intervention that is easy to incorporate into perioperative management for total knee arthroplasty [18].
• The use of a low-cost commercially available amino acid supplement resulted in fewer overall complications postoperatively and was a low-risk intervention for the patient population [26].
• A comprehensive balanced nutrition supplement resulted in lower complication rates and mortality at 120 days postoperatively for hip fracture patients [30].
• Nutrition consultation and perioperative supplementation with amino acids and micronutrients are two readily available interventions that orthopaedic surgeons can select for malnourished patients [22].

Osteoarthritis and Joint Health

• Evidence supports the efficacy of glucosamine sulfate in reducing pain, improving function, and possibly regulating joint damage in knee osteoarthritis [7].

Specific Injury and Rehabilitation

• 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].

General Considerations and Limitations

• Calcium supplements may appear to improve fracture healing of osteoporotic bone but failed to improve strength in a rat model [16].
• The appropriate use of some dietary 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 [12].

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)
• [L4] The evidence supports efficacy in reducing pain, improving function, and possibly regulating joint damage. [7] (10.1186/s12891-022-06046-6)
• [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. [8] (10.1016/j.pain.2007.01.020)
• [L1] CEAA supplementation has a protective effect against common complications and early skeletal muscle wasting after operative fixation of extremity and pelvic fractures. [9] (10.2106/jbjs.21.01014)
• [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. [11] (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). [12] (10.1136/bjsports-2018-099027)
• [L4] Nutritional supplementation has been shown to markedly reduce hospital costs by reducing rates of ICU admissions, hospital-associated complications, and hospital-acquired infections. [14] (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. [15] (10.1016/j.jhsa.2013.05.017)
• [Paper] Therefore, calcium supplements may appear to improve fracture healing of osteoporotic bone but failed to improve strength. [16] (10.1002/jor.21180)
• [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. [18] (10.2106/jbjs.22.01357)
• [L1] Supplementation of n-3 PUFAs is effective to relieve pain and improve joint function in patients with OA. [19] (10.1186/s13018-023-03855-w)
• [L1] The results from this study demonstrate that restoration of the distal vasti muscle mass and knee extension muscle strength with resistance training is promoted further by protein-containing nutrient supplementation immediately after single exercise sessions. [20] (10.1002/jor.20147)
• [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. [21] (10.1177/2325967123s00326)
• [L5] Nutrition consultation and perioperative supplementation with amino acids and micronutrients are 2 readily available interventions that orthopaedic surgeons can select for malnourished patients. [22] (10.2106/jbjs.rvw.23.00242)
• [L1] However, oral nutritional supplementation and dietetic assistance represent low-risk interventions that may improve morbidity and mortality. [23] (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. [24] (10.1186/s12891-024-08244-w)
• [L1] With protein supplementation, protein intakes at amounts greater than ~1.6 g/kg/day do not further contribute RET-induced gains in FFM. [25] (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. [26] (10.2106/jbjs.22.00078)
• [L1] The results demonstrate that patients do not benefit from creatine supplementation during the first 12 weeks of rehabilitation after ACL reconstruction. [28] (10.1177/0363546503261731)
• [L4] Integrating targeted nutrition into prehabilitation pathways may help reduce complications and support faster functional gains. [29] (10.1016/j.arth.2026.03.088)
• [L1] The comprehensive balanced nutrition supplement resulted in lower complication rates and mortality at 120 days postoperatively. [30] (10.1097/01.blo.0000224054.86625.06)
• [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. [32] (10.5435/jaaos-d-25-00757)
• [Paper] These data show a biological action of high concentrations of this supplement and its effect on the mechanical properties in this in vitro model. [34] (10.1002/jor.20757)
• [L5] The findings suggest that EPA supplementation could offer a promising strategy for preventing PTOA progression following acute cartilage injuries. [35] (10.1186/s13018-024-05081-4)
• [Paper] These data suggest that intra-articular injections of HA supplemented with CCL25 attenuates OA. [37] (10.1002/jor.24312)
• [Paper] Supplementation with increasing concentrations of insulin-like growth factor-I enhances chondrocyte matrix synthesis and may provide a means to enhance chondrocyte phenotypic stability and function during transplantation grafting procedures. [38] (10.1002/jor.1100170403)
• [L5] This is the first report providing evidence for the protective role of glucosamine against this early mediator of disc degeneration that could support the potential usage of this molecule as a treatment for preventing disc degenerative disorders. [39] (10.1002/jor.22725)
• [Paper] The beneficial effects of the combination of anabolic growth factors and catabolic blockers were evident in improved preservation of proteoglycan content of cartilage explants exposed to the depleting effects of IL-1. [40] (10.1016/j.orthres.2004.06.020)
• [L1] Oral chondroitin is more effective than placebo on relieving pain and improving physical function, while glucosamine showed effect on stiffness outcome. [43] (10.1186/s13018-018-0871-5)
• [L1] Our findings demonstrate significant pain relief in patients with knee osteoarthritis who received collagen peptides compared to those who received placebo. [45] (10.1186/s13018-023-04182-w)
• [L1] Additionally, patients in the colostrum group had approximately 4 lower Oswestry Disability Index (ODI) scores than the control group over the 90-day study period, indicating improved physical function. [46] (10.1016/j.injury.2023.111253)
• [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. [47] (10.5435/jaaos-d-24-01101)
• [Paper] The article highlights that while amino acids are marketed as ergogenics, peer-reviewed scientific research often fails to support their efficacy for enhancing athletic performance. [49] (10.1016/s0278-5919(05)70173-3)

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

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[7] 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

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