Search

Matteo Briguglio,1 Claudio Cordani,2,3 Francesco Langella,4 Paolo Perazzo,5 Fabrizio Ernesto Pregliasco,6,7 Giuseppe Banfi,3,8 Thomas W Wainwright9,10 1Laboratory of Nutritional Sciences, IRCCS Orthopedic Institute Galeazzi, Milan, Italy; 2Department of Biomedical, Surgical, and Dental Sciences, University “La Statale”, Milan, Italy; 3Scientific Direction, IRCCS Orthopedic Institute Galeazzi, Milan, Italy; 4GSpine4, IRCCS Orthopedic Institute Galeazzi, Milan, Italy; 5Intensive Care Unit, IRCCS Orthopedic Institute Galeazzi, Milan, Italy; 6Health Management, IRCCS Orthopedic Institute Galeazzi, Milan, Italy; 7Department of Biomedical Sciences for Health, University of Milan, Milan, Italy; 8Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy; 9Orthopaedic Research Institute, Bournemouth University, Bournemouth, UK; 10Physiotherapy Department, University Hospitals Dorset NHS Foundation Trust, Bournemouth, UKCorrespondence: Matteo Briguglio, IRCCS Ospedale Galeazzi – Sant’Ambrogio, Via Cristina Belgioioso 173, Milan, 20157, Italy, Tel +0039 02 83502224, Email matteo.briguglio@grupposandonato.itAbstract: Individuals with severe cartilage degeneration of the hip or knee or collapsed vertebrae that cause spine deformities can suffer from joint and neuropathic pain in the back, disuse of the affected limb, and restriction of movements. Surgical intervention is the most widespread and successful solution to date. There is a general belief that eating healthy and staying physically and mentally active might have a preventive role against musculoskeletal disease occurrence, while instead, we are more certain of the benefits deriving from a healthy diet and exercise therapy after major orthopaedic procedures. These aspects are in fact vital components in enhanced recovery after surgery programmes. However, they are applied in hospital settings, are often centre-dependent, and lack primary and tertiary preventive efficacy since end once the

Matteo Briguglio,1 Thomas W Wainwright,2,3 Kate Southern,2,4 Patrizia Riso,5 Marisa Porrini,5 Robert G Middleton2,3 1IRCCS Orthopedic Institute Galeazzi, Laboratory of Nutritional Sciences, Milan, Italy; 2Bournemouth University, Orthopaedic Research Institute, Bournemouth, UK; 3University Hospitals Dorset, NHS Foundation Trust, Poole, UK; 4Nuffield Health Bournemouth Hospital, Bournemouth, UK; 5University of Milan, Department of Food, Environmental and Nutritional Sciences (DeFENS), Milan, ItalyCorrespondence: Matteo Briguglio, IRCCS Orthopedic Institute Galeazzi, Laboratory of Nutritional Sciences, Via Cristina Belgioioso 173, Milan, 20157, Italy, Tel +39 02 8350 2278, Email matteo.briguglio@grupposandonato.itAbstract: Improvements to enhanced recovery pathways in orthopedic surgery are reducing the time that patients spend in the hospital, giving an increasingly vital role to prehabilitation and/or rehabilitation after surgery. Nutritional support is an important tenant of perioperative medicine, with the aim to integrate the patient’s diet with food components that are needed in greater amounts to support surgical fitness. Regardless of the time available between the time of contemplation of surgery and the day of admission, a patient who eats healthy is reasonably more suitable for surgery than a patient who does not meet the daily requirements for energy and nutrients. Moreover, a successful education for healthy food choices is one possible way to sustain the exercise therapy, improve recovery, and thus contribute to the patient’s long-term health. The expected benefits presuppose that the patient follows a healthy diet, but it is unclear which advice is needed to improve dietary choices. We present the principles of healthy eating for patients undergoing major orthopedic surgery to lay the foundations of rational and valuable perioperative nutritional support programs. We discuss the concepts of nutritional use of food, requirements, portion size, dietary

Matteo Briguglio,1 Thomas W Wainwright2,3 1IRCCS Orthopedic Institute Galeazzi, Scientific Direction, Milan, Italy; 2Orthopaedic Research Institute, Bournemouth University, Bournemouth, UK; 3Physiotherapy Department, University Hospitals Dorset NHS Foundation Trust, Bournemouth, UKCorrespondence: Matteo BriguglioIRCCS Orthopedic Institute Galeazzi, Scientific Direction, Via Riccardo Galeazzi 4, Milan, 20161, ItalyTel +39 02 66214978Email matteo.briguglio@grupposandonato.itAbstract: In the past, good food and exercise were not considered effective interventions to promote recovery in orthopedic surgery, and prolonged bed rest with not many calories has been deemed sufficient for the proper health restoration until the end of the nineteenth century. The advancement of scientific knowledge proved just the opposite, thus pushing health professionals to sustain the nutritional status and physical fitness of surgical patients. Nevertheless, the impoverishment of lifestyles and the lengthening of life expectancy have invariably contrasted the strength of constitution, giving rise to two of the most hazardous conditions for orthopedic patients: malnutrition and sarcopenia, often hiding nutrient deficits and poor body composition. These conditions are known to be negative prognostic factors in several areas of major surgery, including hip replacement, knee replacement, and spine surgery. Scoring systems to screen for malnutrition and physical inabilities exist, but disciplined management of the derived risks remains untested, potentially hindering the implementation of research findings into practice. A methodical approach of preoperative analysis, critical monitoring, and risk correction before surgery could lead to a substantial improvement of the prognosis while warranting the safety of patients and the efficiency of enhanced recovery after surgery pathways. The aim of this article is to discuss from a dietetic and exercise perspective the ideal nutritional and physical p

Matteo Briguglio,1,* Jacopo Antonino Vitale,1 Roberta Galentino,2 Giuseppe Banfi,1,3 Carlotta Zanaboni Dina,4 Alberto Bona,5 Giancarlo Panzica,6 Mauro Porta,2,* Bernardo Dell’Osso,7–9,* Ira David Glick9,* 1IRCCS Orthopedic Institute Galeazzi, Scientific Direction, Milan, Italy; 2IRCCS Orthopedic Institute Galeazzi, Tourette’s Syndrome and Movement Disorders Centre, Milan, Italy; 3Department of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy; 4TICEA Center, Scientific Direction, Milan, Italy; 5Neurosurgery Department, ICCS Istituto Clinico Città Studi, Milan, Italy; 6Department of Neuroscience, Rita Levi Montalcini, University of Turin, Turin, Italy; 7University of Milan, Department of Clinical and Biomedical Sciences Luigi Sacco, ASST Fatebenefratelli-Sacco, Ospedale Sacco Polo Universitario, Milan, Italy; 8“Aldo Ravelli” Center for Neurotechnology and Brain Therapeutic, University of Milan, Milan, Italy; 9Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA*These authors contributed equally to this workCorrespondence: Matteo BriguglioIRCCS Orthopedic Institute Galeazzi, Scientific Direction, Via Riccardo Galeazzi, 4, Milan 20161, MI, ItalyTel +39 338 6087042Email matteo.briguglio@grupposandonato.itAbstract: Neuropsychiatric disorders stem from gene-environment interaction and their development can be, at least in some cases, prevented by the adoption of healthy and protective lifestyles. Once full blown, neuropsychiatric disorders are prevalent conditions that patients live with a great burden of disability. Indeed, the determinants that increase the affliction of neuropsychiatric disorders are various, with unhealthy lifestyles providing a significant contribution in the interplay between genetic, epigenetic, and environmental factors that ultimately represent the pathophysiological basis of these impairing conditions.