Patients › General-Health
La vitamina D y la salud musculoesquelética
How vitamin D affects bone, muscle strength, falls, fracture and tendon healing, and surgical outcomes — including who benefits from supplementation.
¿Qué es?¶
La vitamina D es un nutriente que su cuerpo utiliza para formar y mantener el hueso. También interviene en cómo se curan los músculos y los tendones después de una lesión o una cirugía. Cuando su nivel de vitamina D es bajo, se habla de deficiencia de vitamina D.
Un nivel bajo de vitamina D es importante para las personas con problemas de huesos y articulaciones. La investigación relaciona la deficiencia con más roturas del ligamento cruzado anterior, el ligamento de la rodilla que a menudo se lesiona haciendo deporte, y con el fracaso de la reconstrucción de ese ligamento [1]. También se ha relacionado con las fracturas por estrés, que son pequeñas grietas en el hueso causadas por cargas repetidas [2]. Las personas mayores que se rompen un hueso tras una caída leve, lo que se llama fractura por fragilidad, son otro grupo en el que la vitamina D importa para la salud de los huesos [3].
La vitamina D también puede influir en lo bien que se cura después de una cirugía. Los estudios indican que puede favorecer la cicatrización de los tendones, sobre todo después de una reparación del manguito rotador, aunque la investigación hasta ahora es limitada y de calidad modesta [4]. Un nivel bajo de vitamina D antes de la cirugía se ha relacionado con una cicatrización más lenta de la herida después de algunas operaciones de la mano [5], y con complicaciones después de una prótesis de hombro [6]. Por este motivo, su médico puede comprobar su nivel de vitamina D antes de algunas operaciones y tratar la deficiencia si la encuentra.
Dentro de su cuerpo, la vitamina D ayuda a las células que forman hueso a hacer su trabajo. En estudios sobre la consolidación de fracturas, administrar vitamina D mejoró la resistencia del hueso nuevo que se forma a medida que la fractura se suelda [7]. También parece influir en factores inmunitarios que intervienen en la consolidación de las fracturas [8].
No todas las operaciones de las articulaciones necesitan análisis o suplementos de forma rutinaria. Las pruebas no respaldan hacer análisis y dar suplementos de vitamina D de forma rutinaria a todas las personas que se operan de una reparación del manguito rotador [9] o de una prótesis de rodilla [10]. Su médico hablará con usted sobre si tiene sentido comprobar su nivel en su caso.
¿Funciona?¶
La respuesta sincera es que depende de lo que espere que haga la vitamina D. En los huesos rotos, el panorama es bastante positivo. En estudios sobre la consolidación de fracturas, la vitamina D mejoró la resistencia del hueso nuevo que se forma a medida que la fractura se suelda [7]. El tratamiento con una forma activa de vitamina D3 también favoreció la consolidación de las fracturas en personas con osteoporosis, que es un hueso que se ha vuelto delgado y débil [8]. Y cuando mujeres con osteoporosis combinaron la vitamina D con entrenamiento interválico de alta intensidad, su densidad ósea mejoró más que con cualquiera de los dos por separado [11].
Pero algunos resultados apuntan en sentido contrario. Los suplementos combinados de calcio y vitamina D mejoraron la densidad ósea de la pelvis y corrigieron los niveles bajos de vitamina D en mujeres posmenopáusicas con osteoporosis [12]. Sin embargo, esos mismos suplementos no redujeron el número de fracturas que esas mujeres sufrieron realmente [12]. Esa diferencia importa. Un hueso que parece más fuerte en una prueba de imagen no siempre significa menos fracturas.
En las prótesis articulares, los resultados son dispares. Una única dosis alta de vitamina D3 administrada el día de la cirugía de prótesis de rodilla no cambió la recuperación inicial, las complicaciones ni la movilidad de las personas en comparación con una pastilla sin principio activo (placebo) [13]. Las personas que partían de una deficiencia necesitaron suplementos en dosis medias a altas para recuperar sus niveles, e incluso así solo el 33.7% alcanzó un nivel saludable [14]. Por otro lado, mantener niveles adecuados de vitamina D puede mejorar la supervivencia a más largo plazo después de una cirugía por fractura de la parte superior del fémur, el hueso del muslo [15].
En la cicatrización de los tendones, las pruebas no respaldan hacer análisis ni dar suplementos de forma rutinaria a todas las personas que se operan de una reparación del manguito rotador [9]. Un nivel bajo de vitamina D antes de esa operación se asoció con más degeneración grasa en el tendón, pero es poco probable que esto cambie el resultado de la propia reparación [9].
Así que la vitamina D parece útil para la consolidación de los huesos y para corregir una deficiencia real. Está menos claro que mejore la recuperación después de una prótesis articular o de una cirugía de tendones. Su médico puede ayudarle a decidir si tiene sentido comprobar su nivel en su situación.
¿Cuáles son los riesgos?¶
La mayor parte del riesgo no está en el tratamiento con vitamina D en sí. La preocupación mayor es lo que ocurre cuando un nivel bajo pasa desapercibido. La investigación relaciona la deficiencia de vitamina D con problemas después de algunas operaciones, como una cicatrización más lenta de la herida después de ciertas cirugías de la mano [5] y complicaciones después de una prótesis de hombro [6]. La deficiencia también es frecuente en las personas que se operan de una prótesis articular, y más aún en invierno [16]. Por eso su médico puede comprobar su nivel antes de algunas operaciones en lugar de esperar a que aparezca un problema.
Incluso cuando se trata un nivel bajo, no está garantizado que vuelva a subir. Entre los pacientes de prótesis de rodilla que partían de una deficiencia, los suplementos en dosis medias a altas ayudaron, pero muchos siguieron sin alcanzar un nivel saludable [14]. Una única dosis alta de vitamina D3 el día de la prótesis de rodilla no cambió la recuperación inicial ni las complicaciones en comparación con una pastilla sin principio activo (placebo) [13]. Así que más suplemento no siempre significa más beneficio, y su médico hablará con usted sobre qué análisis y tratamiento tienen sentido para su operación.
También hay límites sinceros en lo que muestra la investigación. Las pruebas sobre los suplementos después de una prótesis de rodilla son poco uniformes, y no son lo bastante sólidas como para justificar tratar a todo el mundo [10]. En la reparación del manguito rotador, los estudios indican que la vitamina D puede favorecer la cicatrización del tendón, pero la investigación es de calidad modesta y abarca un solo grupo de tendones [4]. Y aunque un nivel bajo de vitamina D antes de esa operación se asoció con más cambios grasos en el tendón, es poco probable que esto cambie el resultado de la propia reparación [9].
Un último punto que conviene conocer. Los suplementos combinados de calcio y vitamina D mejoraron la densidad ósea en mujeres posmenopáusicas con osteoporosis, pero no redujeron el número de fracturas que esas mujeres sufrieron realmente [12]. Una prueba de imagen con mejor aspecto no siempre significa menos fracturas. Si está pensando en tomar suplementos para la salud de sus huesos, merece la pena hablar de esa diferencia con su médico.
¿Es adecuado para usted?¶
Los análisis y el tratamiento de la vitamina D suelen ser adecuados para las personas que tienen un motivo claro para comprobarla. Si su nivel puede estar bajo antes de una cirugía, sobre todo por debajo de 20 ng/mL, un análisis previo puede orientar el tratamiento [17]. También puede ayudar a prevenir una cicatrización más lenta de la herida después de algunas operaciones de la mano [5]. Las personas con artrosis por desgaste en la rodilla y un nivel bajo de vitamina D pueden tener un dolor articular más extendido, así que también tiene sentido comprobarlo en ese caso [18]. Las personas mayores y las personas con huesos delgados y débiles son otros grupos que a menudo se benefician de un control.
Está menos claro quién no se beneficiará. Las pruebas no respaldan hacer análisis y tratar a todas las personas que se operan de una prótesis de rodilla [10] o de una reparación del manguito rotador [9]. E incluso cuando se trata un nivel bajo, no está garantizado que vuelva a subir. Entre los pacientes de prótesis de rodilla que partían de una deficiencia, los suplementos en dosis medias a altas ayudaron, pero muchos siguieron sin alcanzar un nivel saludable [14].
En comparación con tomar simplemente un suplemento sin hacerse análisis, comprobar primero el nivel permite que el tratamiento se dirija a las personas que realmente lo necesitan. Dicho esto, la investigación sobre este equilibrio es limitada, y el enfoque adecuado depende de su operación y de su salud.
Se trata de una decisión compartida. Hable con su médico de su alimentación, del tiempo que pasa al aire libre y de cualquier fractura previa. Juntos pueden decidir si tiene sentido hacer un análisis de sangre antes de su operación, y qué hacer si el resultado muestra un nivel bajo.
Conclusión¶
Merece la pena pensar en la vitamina D si su nivel puede estar bajo, sobre todo antes de ciertas operaciones. Parece útil para la consolidación de los huesos y para corregir una deficiencia real, pero está menos claro que mejore la recuperación después de una prótesis articular o de una cirugía de tendones. La advertencia más importante: incluso cuando se trata un nivel bajo, no está garantizado que vuelva a subir, así que hable con su médico sobre si tiene sentido hacerse un análisis de sangre.
Referencias¶
[1] A Diagnosis of Vitamin D Deficiency Is Associated With Increased Rates of Anterior Cruciate Ligament Tears and Reconstruction Failure. Arthroscopy. 2023. DOI: 10.1016/j.arthro.2023.04.011
[2] Vitamin D and the Risk of Stress Fractures in Athletes and Military Personnel: A Systematic Review and Meta-analysis. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465261441254
[3] Forgetting the Frail: National Trends in Vitamin D Prescription After Fragility Fracture—A Large Insurance Claims Database Study. Journal of the American Academy of Orthopaedic Surgeons. 2024. DOI: 10.5435/jaaos-d-23-00932
[4] The Role of Vitamin D in Postoperative Tendon Healing: A Scoping Review. Orthopaedic Journal of Sports Medicine. 2025. DOI: 10.1177/23259671251371300
[5] The Effect of Serum Vitamin D Level on Wound Healing Process After Open Carpal Tunnel Release Surgery: Clinical Outcomes of 55 Cases. Journal of the American Academy of Orthopaedic Surgeons. 2025. DOI: 10.5435/jaaos-d-25-00410
[6] Vitamin D deficiency is associated with adverse medical outcomes following total shoulder arthroplasty. JSES International. 2025. DOI: 10.1016/j.jseint.2025.01.010
[7] Effect of 25‐OH‐vitamin D on fracture healing in elderly rats. Journal of Orthopaedic Research. 1998. DOI: 10.1002/jor.1100160604
[8] Determination of immune factor levels in serum and local hematoma samples of osteoporotic fracture patients and clinical study of the effect of active vitamin D3 treatment on immune factor levels. Journal of Orthopaedic Surgery and Research. 2023. DOI: 10.1186/s13018-023-03777-7
[9] Preoperative serum vitamin D deficiency is associated with increased rotator cuff fatty degeneration but is unlikely to influence post repair outcomes: a systematic review and meta-analysis of correlation coefficients. JSES Reviews, Reports, and Techniques. 2025. DOI: 10.1016/j.xrrt.2025.02.006
[10] Effect of Vitamin D Supplementation on Total Knee Arthroplasty Outcomes: A Systematic Review. Orthopaedic Journal of Sports Medicine. 2026. DOI: 10.1177/23259671261432670
[11] Concurrent effects of high-intensity interval training and vitamin D supplementation on bone metabolism among women diagnosed with osteoporosis: a randomized controlled trial. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-08275-x
[12] The effects of combined calcium and vitamin D supplementation on bone mineral density and fracture risk in postmenopausal women with osteoporosis: a systematic review and meta-analysis of randomized controlled trials. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-09089-7
[13] Vitamin D3 Supplementation Prior to Total Knee Arthroplasty: A Randomized Controlled Trial. The Journal of Arthroplasty. 2023. DOI: 10.1016/j.arth.2022.08.020
[14] Vitamin D Supplementation May Prevent or Treat Deficiency After Total Knee Arthroplasty: A Retrospective Cohort Analysis. Journal of the American Academy of Orthopaedic Surgeons. 2024. DOI: 10.5435/jaaos-d-24-00005
[15] 25-Hydroxyvitamin D Levels, Free Serum Calcium, Glomerular Filtration Rate, Albumin, and Femoral Fracture Elderly Patient Mortality. JAAOS: Global Research and Reviews. 2026. DOI: 10.5435/jaaosglobal-d-25-00108
[16] Higher prevalence of vitamin D deficiency among arthroplasty patients presenting in winter. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-06482-9
[17] Impact of Vitamin D Deficiency on Short- and Long-Term Mortality in Patients Receiving Hip Fracture Surgery Under General Anesthesia: A Matched Cohort Study. The Journal of Arthroplasty. 2025. DOI: 10.1016/j.arth.2025.04.080
[18] Association between vitamin D deficiency, inflammatory markers, and knee osteoarthritis: a retrospective study. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-05805-0
Evidence & references
This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.
Overview¶
- A diagnosis of vitamin D deficiency is associated with increased rates of anterior cruciate ligament tears and reconstruction failure [2].
- Vitamin D status should be assessed in high-risk populations to guide preventive strategies focused on maintaining optimal levels for stress fracture risk [3].
- Educational initiatives and revised guidelines may have improved vitamin D prescription rates after fragility fracture, but awareness of the importance of vitamin D for bone health in older adults needs to be raised [4].
- Vitamin D represents a potentially modifiable risk factor that could be optimized during both surgical and nonsurgical management of patients with Charcot arthropathy [5].
- Regular vitamin D supplementation significantly reduces the likelihood of deficiency among arthroplasty patients presenting in winter [6].
- Determining vitamin D levels preoperatively and providing supplementation if deficiency is present may be beneficial for preventing delayed wound healing after open carpal tunnel release surgery [7].
- Evidence suggests vitamin D may support tendon healing, particularly in rotator cuff repair, although studies remain low quality and limited to a single tendon group [8].
- Targeted interventions are needed to optimize musculoskeletal and metabolic health in adolescents with vitamin D deficiency and adverse body composition [9].
- Preoperative vitamin D screening and potential supplementation strategies are important for patients who have vitamin D levels below 20 ng/mL undergoing hip fracture surgery under general anesthesia [10].
- Nonselective preoperative vitamin D supplementation appears to be more cost-effective than selective supplementation in arthroscopic rotator cuff repair, likely due to the lower cost of 25(OH)D supplementation compared to serum assays [11].
- Administering an oral 300,000 U single-dose vitamin D regimen to correct vitamin D deficiency can positively impact outcomes following primary total joint arthroplasty [12].
- Orthopedic surgeons should recognize vitamin D deficiency as a potential modifiable risk factor for postoperative complications in total shoulder arthroplasty [14].
- Current evidence is inconsistent and insufficient to support universal vitamin D supplementation for total knee arthroplasty outcomes [17].
- Findings from a systematic review and meta-analysis do not justify routine testing and supplementation of vitamin D in patients undergoing rotator cuff repair [28].
- Hand grip strength, vitamin D status, and diets might be considered diagnostic non-invasive predictors of bone health for clinical use in epidemiological contexts in 6–12 years old school children [29].
How It Works¶
Mechanisms of Action¶
- BMP signaling plays a role in the induction of an osteoblastic phenotype in human dermal fibroblasts in response to vitamin D3 stimulation [30].
- Retinoic acid and vitamin D are likely to be antagonists of thyroid hormone signaling in the growth plate [33].
- With 1 a,25(OH)2D3 treatment, apoptosis was evident at higher concentrations only in human osteosarcoma cell lines [32].
Bone Healing and Fracture Outcomes¶
- The administration of 25-OH-vitamin D after the production of the experimental fracture improved the mechanical strength of the callus in the healing bone in elderly rats [18].
- Active vitamin D3 treatment promoted fracture healing by affecting the levels of immune factors in osteoporotic fracture patients [19].
- There is a correlation between vitamin D status and radiographic fracture healing outcomes in distal humeral fractures [20].
Tendon and Soft Tissue Healing¶
- Combining systemic and localized vitamin D delivery significantly enhanced tendon-to-bone healing, muscle regeneration, and biomechanical strength in a rabbit rotator cuff tear model compared to other treatment groups [21].
- Evidence suggests vitamin D may support tendon healing, particularly in rotator cuff repair, though studies remain low quality and limited to a single tendon group [8].
- Lower preoperative serum vitamin D levels had a strong correlation with lower tissue vitamin D levels and lower serum vitamin D levels at 1 year after rotator cuff repair [25].
Immune and Metabolic Effects¶
- Supplementation with vitamin D 10,000 IU/day for 8 weeks can increase vitamin D levels >50 ng/dl to optimally act as an immunomodulator in tuberculosis spondylitis patients [15].
- Sixteen weeks of HIIT and vitamin D consumption showed greater benefits for BMD levels in women with osteoporosis than either vitamin D consumption or HIIT training alone [16].
Clinical Implications and Screening¶
- Vitamin D status should be assessed in high-risk populations to guide preventive strategies focused on maintaining optimal levels regarding stress fracture risk [3].
- Preoperative vitamin D screening and potential supplementation strategies are important for patients who have vitamin D levels below 20 ng/mL undergoing hip fracture surgery [10].
What the Evidence Shows¶
Fracture Healing and Bone Health¶
- Administration of 25-OH-vitamin D after experimental fracture production improved the mechanical strength of the callus in healing bone [18].
- Vitamin D status correlates with radiographic fracture healing outcomes in distal humeral fractures [20].
- Sixteen weeks of high-intensity interval training and vitamin D consumption showed greater benefits for bone mineral density levels in women with osteoporosis than either vitamin D consumption or high-intensity interval training alone [16].
- Combined calcium and vitamin D supplementation may improve pelvic bone mineral density and correct serum 25OHD deficiencies in postmenopausal women with osteoporosis [35].
- Combined calcium and vitamin D supplementation does not reduce clinical fracture risk in postmenopausal women with osteoporosis [35].
- Regular sling core stabilization training based on calcium and vitamin D supplementation can improve bone mineral density and prevent low back pain in a patient with primary osteoporosis over a 6-year period [37].
- Vitamin D deficiency is associated with adverse body composition in adolescents [9].
Arthroplasty and Joint Surgery¶
- Although vitamin D status alone may not influence immediate recovery, maintaining adequate levels may improve longer term survival after proximal femoral fracture surgery [34].
- Vitamin D deficiency is associated with adverse medical outcomes following total shoulder arthroplasty [14].
- Supplementation with 50,000 international units vitamin D3 on the day of surgery failed to demonstrate statistically significant differences in functional Knee Society Score, Timed Up and Go Test times, or complications in the early postoperative period compared to placebo in total knee arthroplasty [36].
- Low-dose vitamin D supplementation was beneficial for vitamin D–sufficient total knee arthroplasty patients to achieve higher levels and maintain sufficiency [26].
- Deficient total knee arthroplasty patients benefitted from medium-to-high dose vitamin D supplementation, though only 33.7% achieved repletion [26].
- Preoperative vitamin D supplementation is a cost-effective intervention in arthroscopic rotator cuff repair [11].
- Nonselective vitamin D supplementation appears to be more cost-effective than selective supplementation, likely due to the lower cost of 25(OH)D supplementation compared to serum assays [11].
Tendon and Ligament Pathology¶
- Lower preoperative serum vitamin D levels had a strong correlation with lower tissue vitamin D levels and lower serum vitamin D levels at 1 year after rotator cuff repair surgery [25].
- Preoperative serum vitamin D deficiency is associated with increased rotator cuff fatty degeneration but is unlikely to influence post repair outcomes [28].
- The findings of the systematic review and meta-analysis do not justify routine testing and supplementation of vitamin D in patients undergoing rotator cuff repair [28].
- Further research is necessary to elucidate the direct role of vitamin D in the pathogenesis of rotator cuff tears and its impact on clinical outcomes after rotator cuff surgery and total shoulder arthroplasty [22].
Wound Healing and Infection¶
Other Musculoskeletal Conditions¶
- Vitamin D deficiency is highly prevalent in knee osteoarthritis patients and its severity is associated with bilateral osteoarthritis and polyarthralgia but not with inflammatory markers [24].
General Supplementation and Screening¶
- Educational initiatives and revised guidelines may have improved vitamin D prescription rates after fragility fracture, but there is a need to raise awareness about the importance of vitamin D for bone health, particularly in older adults [4].
- More research is needed to determine the effect of vitamin D supplementation on bone health and injury risk in elite athletes [1].
Practical Considerations¶
Screening and Assessment¶
- Vitamin D status should be assessed in high-risk populations to guide preventive strategies focused on maintaining optimal levels [3].
- Preoperative vitamin D screening is important for patients who have vitamin D levels below 20 ng/mL [10].
- Determining vitamin D levels preoperatively may be beneficial for preventing delayed wound healing after open carpal tunnel release surgery [7].
- Vitamin D deficiency is highly prevalent in knee osteoarthritis patients [24].
- The severity of vitamin D deficiency in knee osteoarthritis patients is associated with bilateral osteoarthritis and polyarthralgia [24].
- The severity of vitamin D deficiency in knee osteoarthritis patients is not associated with inflammatory markers [24].
- Among Americans over the age of 40, the increase in serum HDL-C is related to decreased bone mineral density of the spine only in women aged 40–59 years with vitamin D insufficiency or deficiency [31].
Supplementation Strategies¶
- Regular vitamin D supplementation significantly reduces the likelihood of deficiency [6].
- Nonselective vitamin D supplementation appears to be more cost-effective than selective supplementation in arthroscopic rotator cuff repair [11].
- Nonselective vitamin D supplementation is likely more cost-effective than selective supplementation due to the lower cost of 25(OH)D supplementation compared to serum assays [11].
- Deficient total knee arthroplasty patients benefited from medium-to-high dose vitamin D supplementation [26].
- Only 33.7% of deficient total knee arthroplasty patients achieved repletion with medium-to-high dose vitamin D supplementation [26].
Clinical Implications and Gaps¶
- There is a need to raise awareness about the importance of vitamin D for bone health, particularly in older adults [4].
- Evidence suggests vitamin D may support tendon healing, particularly in rotator cuff repair [8].
- Studies on the role of vitamin D in postoperative tendon healing remain low quality and limited to a single tendon group [8].
- There is a need for targeted interventions to optimize musculoskeletal and metabolic health in adolescents with vitamin D deficiency and adverse body composition [9].
Key Evidence¶
- [L1] More research is needed to determine the effect of vitamin D supplementation on bone health and injury risk in this population. [1] (10.1177/23259671231220371)
- [L3] These results identify a population with increased odds of injury and provide valuable knowledge as we expand our understanding of the relationship between vitamin D and musculoskeletal health. [2] (10.1016/j.arthro.2023.04.011)
- [L3] These findings suggest that vitamin D status should be assessed in high-risk populations to guide preventive strategies focused on maintaining optimal levels. [3] (10.1177/03635465261441254)
- [L3] Educational initiatives and revised guidelines may have improved prescription rates, but there is a need to raise awareness about the importance of vitamin D for bone health, particularly in older adults. [4] (10.5435/jaaos-d-23-00932)
- [L4] Vitamin D represents a potentially modifiable risk factor that could be optimized during both surgical and nonsurgical management of patients with Charcot arthropathy. [5] (10.5435/jaaosglobal-d-22-00162)
- [L3] Regular vitamin D supplementation significantly reduces the likelihood of deficiency. [6] (10.1186/s13018-025-06482-9)
- [L3] Determining vitamin D levels preoperatively and providing supplementation if deficiency is present may be beneficial for preventing delayed wound healing. [7] (10.5435/jaaos-d-25-00410)
- [L4] Although evidence suggests vitamin D may support tendon healing, particularly in rotator cuff repair, studies remain low quality and limited to a single tendon group. [8] (10.1177/23259671251371300)
- [L3] These findings highlight the need for targeted interventions to optimize musculoskeletal and metabolic health during this developmental window. [9] (10.1186/s13018-025-06091-6)
- [L2] These findings highlight the importance of preoperative vitamin D screening and potential supplementation strategies for patients who have vitamin D levels below 20 ng/mL. [10] (10.1016/j.arth.2025.04.080)
- [L4] Nonselective supplementation appears to be more cost-effective than selective supplementation, likely due to the lower cost of 25(OH)D supplementation compared to serum assays. [11] (10.1016/j.jse.2023.05.007)
- [L3] Administering an oral 300,000 U single-dose vitamin D regimen to correct vitamin D deficiency can positively impact outcomes following primary TJA. [12] (10.1016/j.arth.2024.05.012)
- [L3] Orthopedic surgeons should recognize vitamin D deficiency as a potential modifiable risk factor for postoperative complications in TSA. [14] (10.1016/j.jseint.2025.01.010)
- [L1] Supplementation with vitamin D 10,000 IU/day for 8 weeks can increase vitamin D levels >50 ng/dl to optimally act as an immunomodulator. [15] (10.1186/s13018-023-04445-6)
- [L1] Sixteen weeks of HIIT and vitamin D consumption showed greater benefits for BMD levels in women with osteoporosis than either vitamin D consumption or HIIT training alone. [16] (10.1186/s12891-025-08275-x)
- [L2] However, current evidence is inconsistent and insufficient to support universal supplementation. [17] (10.1177/23259671261432670)
- [L5] The administration of 25-OH-vitamin D after the production of the experimental fracture improved the mechanical strength of the callus in the healing bone. [18] (10.1002/jor.1100160604)
- [L2] Active vitamin D3 treatment promoted fracture healing by affecting the levels of these immune factors. [19] (10.1186/s13018-023-03777-7)
- [L4] These findings suggest a correlation between vitamin D status and radiographic fracture healing outcomes. [20] (10.1016/j.injury.2024.111671)
- [L5] Combining systemic and localized vitamin D delivery significantly enhanced tendon-to-bone healing, muscle regeneration, and biomechanical strength in a rabbit rotator cuff tear model compared to other treatment groups. [21] (10.1016/j.jse.2025.12.003)
- [L4] Further research is necessary to elucidate the direct role of vitamin D in the pathogenesis of rotator cuff tears and its impact on clinical outcomes after rotator cuff surgery and total shoulder arthroplasty. [22] (10.5397/cise.2024.00220)
- [L4] Vitamin D deficiency is highly prevalent in knee OA patients and its severity is associated with bilateral OA and polyarthralgia but not with inflammatory markers. [24] (10.1186/s13018-025-05805-0)
- [L4] Lower preoperative serum vitamin D levels had a strong correlation with lower tissue vitamin D levels and lower serum vitamin D levels at 1 year after surgery. [25] (10.1177/03635465221145711)
- [L3] Low-dose vitamin D supplementation was beneficial for vitamin D–sufficient TKA patients to achieve higher levels and maintain sufficiency, while deficient patients benefitted from medium-to-high dose supplementation, though only 33.7% achieved repletion. [26] (10.5435/jaaos-d-24-00005)
- [L1] This study's findings do not justify routine testing and supplementation of vitamin D in patients undergoing RCR. [28] (10.1016/j.xrrt.2025.02.006)
- [L4] These parameters might be considered diagnostic non-invasive predictors of bone health for clinical use in epidemiological contexts. [29] (10.1186/s12891-023-06960-3)
- [Paper] These results suggest that BMP signaling plays a role in the induction of an osteoblastic phenotype in human dermal fibroblasts in response to vitamin D3 stimulation. [30] (10.1002/jor.20728)
- [L4] Among Americans over the age of 40, the increase in serum HDL-C is related to decreased BMD of spine only in women aged 40–59 years with vitamin D insufficiency or deficiency. [31] (10.1186/s13018-022-03491-w)
- [L5] With 1 a,25(OH)2D3 treatment, apoptosis was evident at higher concentrations only. [32] (10.1002/jor.21585)
- [Paper] We conclude that retinoic acid and vitamin D are likely to be antagonists of thyroid hormone signaling in the growth plate. [33] (10.1016/s0736-0266(00)00024-3)
- [L2] Although vitamin D status alone may not influence immediate recovery, maintaining adequate levels may improve longer term survival after PFF surgery. [34] (10.5435/jaaosglobal-d-25-00108)
- [L1] Combined calcium and vitamin D supplementation may improve pelvic BMD and correct serum 25OHD deficiencies in postmenopausal women with osteoporosis, but does not reduce clinical fracture risk in postmenopausal women with osteoporosis. [35] (10.1186/s12891-025-09089-7)
- [L1] Supplementation with 50,000 international units vitamin D3 on the day of surgery failed to demonstrate statistical significant differences in functional KSS, TUGT times, or complications in the early postoperative period compared to placebo. [36] (10.1016/j.arth.2022.08.020)
- [L4] Regular sling core stabilization training based on calcium and vitamin D supplementation can improve bone mineral density and prevent low back pain in a patient with primary osteoporosis over a 6-year period. [37] (10.1186/s12891-023-06896-8)
References¶
[1] Effects of Vitamin D Supplementation in Elite Athletes: A Systematic Review. Orthopaedic Journal of Sports Medicine. 2024. DOI: 10.1177/23259671231220371
[2] A Diagnosis of Vitamin D Deficiency Is Associated With Increased Rates of Anterior Cruciate Ligament Tears and Reconstruction Failure. Arthroscopy. 2023. DOI: 10.1016/j.arthro.2023.04.011
[3] Vitamin D and the Risk of Stress Fractures in Athletes and Military Personnel: A Systematic Review and Meta-analysis. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465261441254
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