Protein target
Recommended perioperative protein intake is approximately 1.6 to 2.0 g/kg/day, ideally beginning 1 to 2 weeks before surgery and continuing for at least 2 weeks postoperatively.
For Clinicians
A practical perioperative nutrition protocol for surgical patients
Orthonutracare is being developed as a structured perioperative nutrition protocol intended to support patients before surgery and through the early postoperative period, with an initial focus on orthopaedic care.
Clinical rationale
Why this belongs in the surgical pathway
Surgery places substantial physiological demands on patients. Nutritional preparation, muscle reserve, and protein intake may all influence how well a patient enters the perioperative period and how well they recover from it.
Orthonutracare is intended to support one practical part of that process: a clearer, more structured perioperative nutrition approach that can sit alongside broader medical, anaesthetic, and rehabilitation care.
The initial focus is on hip and knee arthroplasty, while the broader rationale may also be relevant across other surgical pathways over time.
Protocol overview
The current perioperative framework
The current concept is designed to be short, structured, and clinically usable, combining protein optimisation, creatine supplementation, vitamin support, and perioperative carbohydrate preparation.
Sachet protocol
The current product concept is based on 2 sachets daily, beginning 1 week before surgery and continuing for 2 weeks afterwards.
Per sachet
Each sachet is currently planned to contain approximately 30 g protein, 2 g creatine, and 500 mg vitamin C.
Carbohydrate strategy
The framework also includes carbohydrate loading on the evening before surgery as part of perioperative metabolic preparation.
Usable protocol
How the protocol is intended to be used
The current Orthonutracare concept is designed around a simple perioperative structure that can be incorporated into routine surgical preparation.
Preoperative phase
Protein optimisation is intended to begin 1 to 2 weeks before surgery, with a target intake of approximately 1.6 to 2.0 g/kg/day. The current product concept supports this with 2 sachets daily.
Immediate preoperative phase
The framework includes carbohydrate loading on the evening before surgery as part of a broader perioperative metabolic strategy.
Postoperative phase
Supplementation is intended to continue for at least 2 weeks after surgery, with emphasis on maintaining protein intake, supporting muscle preservation, and improving early recovery support.
Why protein is central
Muscle preservation and recovery sit at the centre
Protein is central to this concept because the perioperative period increases demands on tissue repair, muscle preservation, immune support, and functional recovery.
In practice, many patients are unlikely to achieve a meaningful perioperative protein intake consistently through normal diet alone, particularly when appetite, mobility, confidence, or routine are already compromised in the lead-up to surgery.
A structured protein target of 1.6 to 2.0 g/kg/day creates a clearer framework for perioperative preparation, while the sachet-based format is intended to make that target easier to reach in real-world care.
Private and public pathways
Designed for real-world practice
Orthonutracare is being developed to be usable across both private and public orthopaedic pathways. The protocol is intended to be simple, scalable, and practical enough to fit existing systems without adding unnecessary complexity.
Potential settings include private surgical practice, public hospital pathways, pre-admission clinics, and enhanced recovery programmes.
Patient groups
Who this may be most relevant for
The initial emphasis is on patients preparing for hip or knee replacement, though the broader perioperative rationale may extend to other surgical groups over time.
In particular, the concept may be useful where protein intake is likely to be suboptimal, muscle reserve is a concern, or clinicians want a more deliberate and structured nutritional pathway before surgery.
Clinical positioning
Measured language, practical intent
Orthonutracare is being developed with deliberately restrained language. The aim is not to overstate certainty or make broad therapeutic promises, but to present a clinically literate and usable perioperative nutrition protocol.
The emphasis is on practical support, preparation, muscle preservation, and recovery context rather than exaggerated marketing language.
Clinician interest
Interested in following the protocol development?
If you are a surgeon, GP, dietitian, nurse, physiotherapist, or part of a perioperative team and would like updates on the development of Orthonutracare, we would be pleased to hear from you.