Effects of Preoperative Whey Protein and Exercise Support on Recovery After Total Hip Arthroplasty (THA)

The Effect of Preoperative Whey Protein and Physical Exercise Support on Recovery After Total Hip Arthroplasty

Objective:

The aim of this project is to evaluate the effects of preoperative whey protein supplementation and a physical exercise program on postoperative recovery outcomes in patients undergoing total hip arthroplasty (THA). Specifically, inflammatory markers (CRP), nutritional status (albumin), mobilization time, length of hospital stay, and physical and social functioning will be assessed. As one of the first randomized controlled trials in Turkey to focus on the preoperative period and to evaluate a combined nutrition and exercise intervention in elderly surgical patients, this study holds pioneering significance in both clinical and academic contexts.

Methods:

This study is designed as a randomized controlled trial. The intervention group will receive whey protein supplementation and a home-based exercise program for 14 days preoperatively, while the control group will receive standard preoperative care. Data collection will be performed preoperatively and on postoperative days 3 and 5, focusing on metabolic and functional parameters.

Expected Outcomes:

The findings of this study are expected to contribute to the improvement of patient care through a multidisciplinary approach, inform health policy development, and provide a foundation for larger-scale clinical research in Turkey.

Study Overview

• Status: Completed
• Conditions: Exercise Training; Nutrition; Geriatric Assessment; Preoperative; Arthoplasty
• Intervention / Treatment: Dietary supplement: Preoperative Whey Protein and Exercise Program

Detailed Description

Background:

Hip osteoarthritis (HOA) is a common degenerative disease in older adults that leads to pain, deformity, and functional loss, thereby reducing quality of life. Muscle atrophy, neuromuscular dysfunction, and pain are frequently observed in the affected limb, resulting in decreased muscle strength. Gait analyses have shown reduced hip range of motion (ROM), decreased walking speed, and diminished hip flexion and abduction moments.

Total hip arthroplasty (THA), widely used in the treatment of HOA, is also performed for femoral fractures, arthritis, developmental hip dysplasia, and osteonecrosis. Although THA is an effective surgical method, delayed wound healing, infection risk, muscle weakness, and mobilization limitations remain important postoperative challenges. With postoperative pain reduction, hip function and quality of life improve significantly. However, diminished proprioception may cause balance problems, increasing the risk of falls.

Exercise therapy plays a key role in postoperative rehabilitation after THA. Physiotherapists provide gait training, ROM exercises, and balance activities. Exercise therapy reduces pain and increases physical activity levels. Systematic reviews have demonstrated the positive effects of exercise on muscle strength and gait performance following THA.

Nevertheless, delayed wound healing, infection, increased morbidity and mortality, and prolonged hospitalization may still occur after THA. In this context, preoperative nutritional support plays a critical role in improving patient outcomes. Protein-based supplements can support muscle protein synthesis and accelerate recovery. Increased protein intake helps prevent muscle breakdown and supports recovery. Thus, selecting an appropriate nutritional and exercise strategy is essential in the postoperative management of orthopedic patients.

Whey protein (WP) is a protein source rich in branched-chain amino acids (BCAAs) and essential amino acids, with high bioavailability and easy digestibility. WP has been shown to stimulate muscle protein synthesis, enhance recovery, and reduce postoperative infection risk.

In Turkey, the surgical needs of the elderly population are steadily increasing, and THA procedures are becoming a major healthcare requirement, especially in older age groups. While the separate effects of exercise and protein supplementation on postoperative outcomes have been demonstrated, there is no study in Turkey evaluating the combined impact of these two interventions when applied in the preoperative period.

This project aims to be the first randomized controlled trial in elderly THA patients to investigate the effects of oral whey protein supplementation combined with a preoperative exercise program on metabolic markers, early mobilization, and length of hospital stay. Both interventions are safe, cost-effective, and easy to apply, and they allow elderly patients to continue daily activities without additional effort or time burden. This project is expected to contribute significantly to the literature by offering an innovative approach in postoperative THA management and by generating scientific evidence on the interaction between nutrition, exercise, and surgical outcomes. The study will be conducted under the supervision of an experienced orthopedic surgeon, with methodological and practical support from clinical dietitians and physiotherapists. The intervention design, data collection, and analysis procedures are planned in accordance with the literature and scientific standards.

• Study Type: Interventional
• Enrollment (Actual): 62
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Talas
    • Kayseri, Talas, Turkey (Türkiye), 38260
      • Erciyes unıversity

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Aged between 50 and 70 years
• Scheduled for elective total hip arthroplasty (THA)
• Able to participate in the preoperative intervention for at least 2 weeks
• Conscious and able to communicate

Exclusion Criteria:

• Patients with advanced malnutrition
• Patients with active cancer, malabsorption, liver or kidney failure
• Patients with severe cognitive impairment
• Patients with health conditions that prevent participation in exercise

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention Group: "Preoperative Whey Protein Supplementation and Exercise Program; The preoperative exercise and protein supplementation program will be conducted by patients in their home environment. Patients will be enrolled in the study 14 days prior to the scheduled surgery. At the start of the program, all patients will receive face-to-face instructions, and data will be collected under the supervision of an experienced orthopedic surgeon at the hospital	Dietary supplement: Preoperative Whey Protein and Exercise Program; The intervention group will receive 14 days of preoperative whey protein supplementation combined with a home-based exercise program. Patients will receive face-to-face instructions at program initiation, and data will be collected under the supervision of an experienced orthopedic surgeon; Other Names: Dietary Supplement + Behavioral (Exercise)
No Intervention: Control Group: "Standard Preoperative Care"; Patients in the control group will receive only the hospital's standard preoperative care protocol. This care includes: Daily monitoring of vital signs Preoperative laboratory tests Anesthesia pre-assessment Surgical information and counseling Medication management No additional protein supplementation or exercise training will be provided specifically to this group.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Serum Albumin Level	Postoperative serum albumin levels measured on days 3 and 5 after total hip arthroplasty.	5 days
C-Reactive Protein (CRP) Level	Postoperative serum CRP levels measured on days 3 and 5 after total hip arthroplasty.	5 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Time to Mobilization	Time (in hours) from surgery completion to first independent mobilization.	5 days
Length of Hospital Stay	Total duration of hospital stay (in days) after surgery.	5 days
Physical and Social Functioning	Assessment of patients' physical and social functioning using standardized scales.	5 days

Collaborators and Investigators

• Sponsor: TC Erciyes University

Publications and helpful links

General Publications

• Adebero T, Omana H, Somerville L, Lanting B, Hunter SW. Effectiveness of prehabilitation on outcomes following total knee and hip arthroplasty for osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. Disabil Rehabil. 2024 Dec;46(24):5771-5790. doi: 10.1080/09638288.2024.2313128. Epub 2024 Feb 13.

Study record dates

Study Major Dates

• Study Start (Actual): September 25, 2025
• Primary Completion (Actual): January 15, 2026
• Study Completion (Actual): April 30, 2026

Study Registration Dates

• First Submitted: December 2, 2025
• First Submitted That Met QC Criteria: December 28, 2025
• First Posted (Actual): January 9, 2026

Study Record Updates

• Last Update Posted (Actual): May 5, 2026
• Last Update Submitted That Met QC Criteria: May 3, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Exercise; Elderly Patients; Whey Protein; Functional Outcomes; Total Hip Arthroplasty (THA); Postoperative Recovery; Preoperative Nutrition
• Additional Relevant MeSH Terms: Behavior; Motor Activity; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena; Food; Diet, Food, and Nutrition; Physiological Phenomena; Food and Beverages; Exercise; Dietary Supplements
• Other Study ID Numbers: 010203

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No