Dietary Supplements

Supplementation with Bromelain, Troxerutin, and Escin to Support Postoperative Recovery After Hip or Knee Arthroplasty in Older Adults: A Pilot Study.

TL;DR

Combined bromelain, troxerutin, and escin supplementation was associated with meaningful reductions in postoperative pain and edema and with faster functional recovery in older adults undergoing rehabilitation after hip or knee arthroplasty.

Key Findings

Supplemented participants achieved significantly greater pain reduction at day 10 compared to controls.

  • VAS scores in the supplemented group declined from 6.8 ± 1.0 to 3.2 ± 0.9 at day 10 (T1)
  • Control group VAS scores declined from 6.7 ± 1.1 to 4.5 ± 1.0 at day 10
  • Difference between groups was statistically significant (p < 0.01)
  • Both groups had similar baseline pain scores prior to intervention

Supplemented participants achieved significantly greater pain reduction at day 21 compared to controls.

  • VAS scores further decreased to 1.8 ± 0.7 in the supplemented group at day 21 (T2)
  • Control group VAS scores at day 21 were 3.1 ± 0.8
  • Difference between groups was statistically significant (p < 0.001)
  • The magnitude of between-group difference was larger at day 21 than at day 10

Functional performance improved more markedly in the supplemented group, with earlier mobilization and faster recovery of autonomy.

  • Secondary outcomes included changes in postoperative edema and functional recovery evaluated through range of motion, the Barthel Index, and gait performance
  • The supplemented group showed earlier mobilization and faster recovery of autonomy compared to controls
  • No specific numerical values for Barthel Index, range of motion, or gait performance outcomes were reported in the abstract

No significant side effects were reported in participants receiving the combined supplement.

  • The supplement was administered orally at doses of bromelain 400 mg/day, troxerutin 300 mg/day, and escin 40 mg/day
  • Supplementation was provided for up to 21 days alongside usual care and standard medications
  • Safety was evaluated in the context of a post-acute rehabilitation unit setting in older adults

The study enrolled 40 older adults admitted to a post-acute rehabilitation unit after total hip or total knee arthroplasty.

  • Mean age of participants was 69.4 ± 7.2 years
  • 58 percent of participants were women
  • Half of the participants (n = 20) received the oral supplement; the other half received standard treatment only
  • The study was a retrospective observational pilot study

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Citation

Landi F, Tosato M, Terranova R, Rubini G, Mammarella F, Cacciatore S, et al.. (2025). Supplementation with Bromelain, Troxerutin, and Escin to Support Postoperative Recovery After Hip or Knee Arthroplasty in Older Adults: A Pilot Study.. Nutrients. https://doi.org/10.3390/nu17243815