Creatine monohydrate supplementation does not improve functional recovery after total knee arthroplasty

OBJECTIVE: To determine if creatine monohydrate supplementation can improve body composition and enhance recovery after total knee arthroplasty (TKA). DESIGN: Randomized trial in which creatine monohydrate or placebo was administered. SETTING: Public primary care facility. PARTICIPANTS: Thirty-seven adults (17 men, 20 women) with osteoarthritis undergoing TKA. Intervention Subjects received creatine monohydrate (10 g/d x 10 d presurgery to 5 g/d x 30 d postsurgery) or placebo. MAIN OUTCOME MEASURES: Body composition (dual-energy x-ray absorptiometry scanning), muscle metabolite concentrations (adenosine triphosphate, phosphocreatine, creatine, total creatine [phosphocreatine + creatine]), muscle histomorphometery, quadriceps, ankle dorsiflexion and handgrip strength, and functional capacity. All measurements were completed preoperatively (-7 d) and 30 days postoperatively, except for that of muscle metabolites. Muscle metabolite samples were collected during surgery (0 d) and at 30 days. RESULTS: A significant decrease in quadriceps and ankle dorsiflexion strength was observed at 30 days postoperatively (P < .01). There were no significant effects of creatine monohydrate supplementation on any of the measured outcome variables. CONCLUSIONS: Creatine monohydrate supplementation did not improve body composition or muscle strength when given before surgery, nor did it enhance recovery after TKA.