This study aim to compare the efficacy of oral nutritional supplementation (ONS) in femoral neck fracture patients undergoing hip arthroplasty compared with placebo. The hypothesis is "Oral nutritional supplement with Beta-hydroxy-beta-methylbutyrate (HMB) can improve muscle strength in femoral neck fracture patients undergoing hip arthroplasty". Femoral neck fracture patients aged more than 65 years will be enrolled and allocated into 2 groups * ONS group: Oral nutritional supplement (Ensure® Plus Advance) 2 serves / day x 30 days + Standard oral intake * Control group: Standard oral intake Primary outcome is Grip strength, assessed using hand dynamometer on admission and 2, 6, 12 weeks postoperatively. Secondary outcomes are * Serum albumin assessed on admission and 2, 6, 12 weeks postoperatively * Barthel index assessed at 2, 6, 12 weeks postoperatively * Mini Nutritional Assessment (MNA), Geriatric Nutritional Risk Index (GNRI) assessed at 2, 6, 12 weeks postoperatively * Length of stay (day) * Time up and go (TUG), assessed at 2, 6, 12 weeks postoperatively * Oxford hip score (OHS), assessed at 2, 6, 12 weeks postoperatively * Complications, rate of readmission, mortality rate assessed until 3 months
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
60
Oral nutritional supplement that consists of 20 grams of protein, 1.5 grams of calcium β-hydroxy-β-methylbutyrate (CaHMB), 0.5 gram of calcium, 500 international units (IU) of vitamin D and calories of 330 kcal per one bottle of 220 ml (Ensure® Advance Plus, Abbott Laboratorios S.A.)
Thammasat University
Pathum Thani, Thailand
Hand grip strength
Hand grip strength, assess using hand dynamometer
Time frame: 12 weeks postoperatively
Hand grip strength
Hand grip strength, assess using hand dynamometer
Time frame: 2, 6 weeks postoperatively
Body weight
Time frame: 2, 6, 12 weeks postoperatively
Body mass index (BMI)
Time frame: 2, 6, 12 weeks postoperatively
Serum albumin
Time frame: 2, 6, 12 weeks postoperatively
Time up and go (TUG)
Performance-based outcome
Time frame: 2, 6, 12 weeks postoperatively
Oxford hip score (OHS)
Patient-reported outcomes measurement of the hip function. Scores range from 0 to 48. Higher scores mean greater hip function and less pain.
Time frame: 2, 6, 12 weeks postoperatively
Barthel index
Index for Activities of Daily Living. Scores range from 0 to 100, with higher scores mean the person is more independent.
Time frame: 2, 6, 12 weeks postoperatively
Mini Nutritional Assessment (MNA)
Validated tool for assessment of elderly nutritional status. Scores range from 0 to 30. The higher scores mean normal nutritional status of the participants.
Time frame: 2, 6, 12 weeks postoperatively
Geriatric Nutritional Risk Index (GNRI)
A tool used to evaluate nutritional risk, morbidity, and mortality in older adults. Scores are calculated from serum albumin and body weight of the participants (No range). Higher scores means low risk of malnutrition.
Time frame: 2, 6, 12 weeks postoperatively
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