Effects of macro- and micronutrient intake on bone mineral density, osteoporotic fracture risk, inflammation, and functional rehabilitation outcomes in orthopedic patients: a systematic review and meta-analysis.

BACKGROUND

Nutritional and therapeutic methods are used to enhance bone health and assist in fracture healing while improving functional ability and reducing inflammation and bettering surgical results. The overall effectiveness of these methods for multiple applications remains unknown. This meta-analysis assessed the impact of various treatments on patients with orthopedic and musculoskeletal disorders.

METHODS

The systematic review examined 95 studies which were organized into seven distinct outcome domains. The study used random-effects meta-analysis with inverse variance weighting to determine standardized mean differences (SMD) and 95% confidence intervals (CI). The study used the Jadad scale and Cochrane Risk of Bias and GRADE criteria to evaluate study quality while the researchers used funnel plots and Egger's test to assess publication bias.

RESULTS

Interventions significantly improved BMD (SMD = 0.47; 95% CI: 0.31-0.62; p < 0.001; I2 = 79%), bone turnover markers (SMD = -0.69; 95% CI: -1.17 to -0.20; p = 0.004; I2 = 99%), inflammation/oxidative stress markers (SMD = -1.34; 95% CI: -1.45 to -1.23; p < 0.001; I2 = 0%), and postoperative recovery/metabolic outcomes (SMD = -2.04; 95% CI: -2.31 to -1.77; p < 0.001; I2 = 86%). No significant effects were observed for fracture healing (SMD = -0.43; 95% CI: -0.96-0.10), functional/muscle outcomes (SMD = 0.37; 95% CI: -0.06-0.80), or miscellaneous outcomes (SMD = -0.40; 95% CI: -0.96-0.16).

CONCLUSION

The study results demonstrate that nutritional and therapeutic treatments lead to better bone density results together with improved biochemical markers and reduced inflammation and faster recovery after surgery. Heterogeneity and risk of bias underline the need for further high-quality randomized trials.