26dkou487 10.3205/26dkou487 urn:nbn:de:0183-26dkou4872 Meeting Abstract Zaidi Zaidi Hussain H

Imperial College London, Department of Bioengineering, St. George’s University of London, London, UK

author Jackson Jackson William W

Oxford University Hospitals NHS, Nuffield Orthopaedic Centre, University of Oxford, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), Oxford, UK

author Alvand Alvand Abtin A

Oxford University Hospitals NHS, Nuffield Orthopaedic Centre, University of Oxford, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), Oxford, UK

author Price Price Andrew A

Oxford University Hospitals NHS, Nuffield Orthopaedic Centre, University of Oxford, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), Oxford, UK

author Wickline Wickline Andrew A

Department of Orthopedic Surgery, Genesee Orthopedics, New Hartford, New York, USA

author Jazayeri Jazayeri Reza R

Department of Sports Medicine, Permanente Medical Group Los Angeles, Los Angeles, CA, USA

author Tsiridis Tsiridis Eleftherios E

Aristotle University of Thessaloniki, Academic Orthopaedic Department, Campus PGH, Thessaloniki, Griechenland

author Wassilew Wassilew Georgi G

Universitätsmedizin Greifswald, Klinik für Orthopädie, Unfallchirurgie und Rehabilitative Medizin, Greifswald, Deutschland

author Maslaris Maslaris Alexander A

Universitätsmedizin Greifswald, Klinik für Orthopädie, Unfallchirurgie und Rehabilitative Medizin, Aristotle University of Thessaloniki, Academic Orthopaedic Department, Campus PGH, Thessaloniki, Griechenland

author German Medical Science GMS Publishing House

Düsseldorf

610 20261020 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0659 487 Deutsche Gesellschaft für Orthopädie und Unfallchirurgie Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie Deutsche Gesellschaft für Unfallchirurgie Berufsverband für Orthopädie und Unfallchirurgie Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2026) Poster | Obere Extremität, konservative Therapie und angrenzende Themen Berlin 20261020 20261023 DKOU26_Abs_2384 TextObjectives and questions: Creatine is a widely used ergogenic supplement known to enhance short-duration, high-intensity performance, yet its role in the management of knee osteoarthritis (OA) and in support of the patient pathway around knee arthroplasty (TKA) remains uncertain. This systematic review aims to evaluate the effects, benefits, risks and optimal dosing of Creatine Monohydrate supplementation and integration of supplementation into TKA prehabilitation pathways to support Enhanced Recovery After Surgery (ERAS).Material and methods: A systematic review was conducted in full accordance with the PRISMA 2020 guidelines. Major databases were searched through September 2025 for RCTs and prospective studies. Primary outcomes were functional performance, strength, patient-reported outcome measures (PROMS); secondary outcomes included renal safety. Given limited OA-specific trials, broader RCTs involving combining creatine supplementation with resistance training were included for context.Results: 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. Nine non-TKA specific RCTs 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, though several are registered. Notably, this represents a missed opportunity within ERAS-driven peri-operative care, where modifiable prehabilitation strategies with proven safety and physiological benefit remain underutilised.Discussion and conclusions: Creatine is not disease-modifying for OA but is a safe, low-cost adjunct that enhances muscular rehabilitation when combined with resistance training. Incorporating creatine supplementation into TKA protocols may have some value and future creatine specific TKA studies are justified. 0 0 0 0