1175 Does Creatine Supplementation Improve Outcomes in Total Knee Arthroplasty? a PRISMA Systematic Review
Abstract
Creatine is a widely used ergogenic supplement known to enhance short-duration, high-intensity performance, yet is role in the management of knee osteoarthritis (OA) and in the perioperative management of total knee arthroplasty (TKA) remains uncertain. This systematic review aims to evaluate the effects, benefits, risks and optimal dosing of Creatine Monohydrate supplementation and integration into TKA prehabilitation to support Enhanced Recovery After Surgery (ERAS).
A Systematic Review was conducted in full accordance with the PRISMA 2020 guidelines. Major databases were searched through September 2025 for Randomised Controlled and prospective studies. Primary outcomes were functional performance, strength, patient-reported outcomes; secondary outcomes included renal safety. Given limited OA-specific trials, broader RCTs involving older adults combining creatine with resistance training were included for context.
Four OA-specific RCTs met inclusion criteria. Creatine combined with resistance training improved function and lean mass versus placebo, while creatine alone did not significantly affect KOOS scores, strength or biomarkers. A renal sub study confirmed no impairment of glomerular filtration rate. Broader RCTs not specific to TKA investigating the effects of creatine supplementation with resistance training consistently demonstrated gains in strength and lean mass when creatine was paired with resistance training. No recent trials have evaluated outcomes post-TKA,…
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