Changes in Resting Metabolic Rate Following Orthopedic Surgery

NCT06107959 — Recruiting, 100 participants, University of Kansas Medical Center

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Registry	NCT06107959
Status	Recruiting
Study type	Observational
Enrollment	100 (Estimated)
Sponsor	University of Kansas Medical Center (Other)
Conditions	Metabolism; Disorder, Postprocedural, Resting Metabolic Rate, Post Operative Nutrition
Interventions	Pre-surgical nutrition, hydration, RMR, and body composition assessments, Post-surgical nutrition, hydration, RMR and body composition assessments (Other)
Dates	start 2023-10-10, primary completion 2027-06-01 (estimated), completion 2027-12-01 (estimated), first posted 2023-10-30, last updated 2026-06-02
Locations	1 site in United States

-Summary

This project is intended to determine the magnitude and duration of RMR changes in patients receiving orthopedic surgery. The result will help to guide postoperative nutrition recommendations in patients receiving orthopedic surgery.

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+Detailed description

Surgery produces a catabolic response in the body that shifts metabolism from glucose to fat and protein. Despite no studies examining ACLR, studies of other orthopedic surgeries demonstrate increased postoperative energy expenditure, as well as a shift to beta-oxidation. Additionally, in most patients, these changes reverted to baseline within six weeks, although a subset of patients did not return to baseline until beyond 12 weeks.

This project will improve our understanding of magnitude and duration of RMR changes following orthopedic surgery, and the subsequent perioperative dietary suggestions that should be made to improve patient outcomes. Currently, postoperative dietary suggestions are not surgery nor patient specific. Determining how orthopedic surgery effects RMR will help to personalize perioperative treatment, rehabilitation, and recovery.

Better understanding the change in RMR following orthopedic surgery and implementing more accurate dietary modifications will help to ensure positive outcomes and control of infection following orthopedic surgery.

+Arms and interventions

Arm	Type	Interventions	Description
Male		Other: Pre-surgical nutrition, hydration, RMR, and body composition assessments; Other: Post-surgical nutrition, hydration, RMR and body composition assessments	50 male subjects undergoing orthopedic surgery.
Female		Other: Pre-surgical nutrition, hydration, RMR, and body composition assessments; Other: Post-surgical nutrition, hydration, RMR and body composition assessments	50 female subjects undergoing orthopedic surgery

Pre-surgical nutrition, hydration, RMR, and body composition assessments (Other): Urine sample, InBody device platform, Metabolic cart with hood to collect RMR.
Post-surgical nutrition, hydration, RMR and body composition assessments (Other): Same as pre-surgical tests at 1 week, 3 weeks, 6 weeks, and 12 weeks follow up time points.

+Outcome measures

Primary outcomes

To determine the magnitude of the change in RMR of patients receiving orthopedic surgery. [12 weeks]: RMR = (9.99 X actual weight*)+ (6.25 X height*) - (4.92 X age) - 161*use weight in kilograms (kilogram), height in centimeters (cm).
To observe the amount of time it takes the RMR to return to baseline. [12 weeks]: calculation in number of weeks

+Eligibility

Sex: All, ages: 15 Years to any

Inclusion Criteria:

* Any individual over 15 undergoing an orthopedic surgery.

Exclusion Criteria:

* Pregnant female
* < 15 years old

+Locations (1)

Facility	City	Country	Status
The University of Kansas Medical Center	Kansas City, Kansas	United States	Recruiting

+Publications

Braga M, Baccari P, Scaccabarozzi S, Fiacco E, Radaelli G, Gallus G, DiPalo S, DiCarlo V, Cristallo M. Prognostic role of preoperative nutritional and immunological assessment in the surgical patient. JPEN J Parenter Enteral Nutr. 1988 Mar-Apr;12(2):138-42. doi: 10.1177/0148607188012002138. PMID 3283387
Hu SS, Fontaine F, Kelly B, Bradford DS. Nutritional depletion in staged spinal reconstructive surgery. The effect of total parenteral nutrition. Spine (Phila Pa 1976). 1998 Jun 15;23(12):1401-5. doi: 10.1097/00007632-199806150-00019. PMID 9654632
Lenke LG, Bridwell KH, Blanke K, Baldus C. Prospective analysis of nutritional status normalization after spinal reconstructive surgery. Spine (Phila Pa 1976). 1995 Jun 15;20(12):1359-67. PMID 7676333
Ljungqvist O, Soop M, Hedstrom M. Why metabolism matters in elective orthopedic surgery: a review. Acta Orthop. 2007 Oct;78(5):610-5. doi: 10.1080/17453670710014293. No abstract available. PMID 17966019
Malone DL, Genuit T, Tracy JK, Gannon C, Napolitano LM. Surgical site infections: reanalysis of risk factors. J Surg Res. 2002 Mar;103(1):89-95. doi: 10.1006/jsre.2001.6343. PMID 11855922
McMulkin ML, Ferguson RL. Resting energy expenditure and respiratory quotient in adolescents following spinal fusion surgery. Spine (Phila Pa 1976). 2004 Aug 15;29(16):1831-5. doi: 10.1097/01.brs.0000134564.24874.10. PMID 15303030