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Vitamina D y salud musculoesquelética

How vitamin D affects bone, muscle strength, falls, fracture and tendon healing, and surgical outcomes — including who benefits from supplementation.

Updated Sep 2026
Un sol brilla sobre un hueso.
La vitamina D, la “vitamina del sol”, es esencial para la fortaleza ósea y el funcionamiento muscular. Kieran Hirpara 4.0

Esta página se tradujo automáticamente y todavía no la ha revisado un médico. La versión en inglés es la versión oficial.

¿Qué es?

La vitamina D es un nutriente que el cuerpo necesita para formar y mantener los huesos. La piel la produce a partir de la luz solar; también se obtiene de ciertos alimentos y suplementos. Cuando los niveles de vitamina D son bajos, se denomina deficiencia de vitamina D.

Los niveles bajos de vitamina D afectan a los huesos y articulaciones. Se ha relacionado con un mayor riesgo de desgarros ligamentarios en la rodilla, así como con una mayor probabilidad de que un ligamento reconstruido fracase [1]. También se asocia con fracturas por estrés; por ello, a menudo se miden los niveles en personas con mayor riesgo de sufrir este tipo de lesiones [2]. En personas mayores, la deficiencia de vitamina D influye en la salud ósea tras una fractura producida por una simple caída [3].

El médico podría medir sus niveles de vitamina D en el momento previo a la cirugía. Los niveles bajos antes de la operación se han vinculado con una cicatrización más lenta y con ciertas complicaciones tras un reemplazo articular [4] [5]. Evaluar los niveles con antelación permite detectar y tratar la deficiencia, en lugar de pasarla por alto [6].

Aún se está investigando cómo ayuda exactamente la vitamina D. Interviene en la curación ósea y en el funcionamiento del sistema inmunitario. También podría favorecer la recuperación de los tendones; sin embargo, la investigación hasta ahora es limitada y se ha centrado en un único grupo de tendones [7]. Todavía no hay respuestas claras para todas las preguntas. Por ejemplo, la evidencia actual no respalda la administración rutinaria de suplementos de vitamina D a todos los pacientes sometidos a reemplazo de rodilla [8], ni tampoco justifica realizar pruebas de rutina en todos los casos de reparación del manguito rotador según los estudios actuales [9].

En resumen, la vitamina D es un elemento esencial para el cuerpo; sus niveles bajos constituyen un factor de riesgo que se puede detectar mediante un sencillo análisis de sangre y tratar. Su importancia para usted dependerá de su estado de salud, del tratamiento previsto y de sus niveles actuales.

¿Funciona realmente?

La respuesta honesta es que depende de lo que se espere lograr con la vitamina D.

En lo que respecta a los huesos, la situación está más clara. En mujeres posmenopáusicas con osteoporosis, la ingesta conjunta de calcio y vitamina D mejoró la densidad ósea de la pelvis y corrigió los niveles sanguíneos bajos [1]. No obstante, el mismo estudio determinó que no reducía el riesgo de fracturas [1]. En otras palabras, ayuda a que los huesos se vean mejor en las imágenes de diagnóstico, pero hasta ahora eso no se ha traducido en una disminución del número de fracturas.

En el ámbito quirúrgico, los resultados son variados. Los niveles bajos de vitamina D antes de una operación se han asociado con complicaciones tras un reemplazo de hombro; este problema, sin embargo, puede corregirse previamente [2]. Por otro lado, administrar una dosis alta de vitamina D el día de una cirugía de reemplazo de rodilla no influyó en la recuperación de los pacientes, ni en la rapidez con que volvían a moverse, ni en la tasa de complicaciones, en comparación con un placebo [3]. En cuanto a la reparación del manguito rotador, una revisión concluyó que no existen pruebas suficientes para justificar la administración de suplementos a todos los pacientes [4].

Existen verdaderas lagunas en la investigación: muchos estudios son de tamaño reducido, y algunos hallazgos provienen de experimentos en animales en lugar de ensayos clínicos en humanos [5]. Los investigadores aún intentan determinar quiénes se benefician de las pruebas, quiénes se benefician del tratamiento y cuánta importancia tiene realmente la vitamina D en la cicatrización postquirúrgica.

Para usted, la conclusión es sencilla: la vitamina D es importante para la salud ósea, y es conveniente detectar y corregir sus niveles bajos. No obstante, no hay pruebas fehacientes de que mejore el resultado de las cirugías ni acelere la cicatrización; por ello, no se recomienda administrarla a todo el mundo de forma automática. Su médico evaluará su estado de salud, el tratamiento previsto y los resultados de sus análisis de sangre para decidir si la vitamina D resulta pertinente en su caso.

¿Cuáles son los riesgos?

El tratamiento con vitamina D no está exento de riesgos; la realidad es que algunos efectos se observan, pero otros no.

El problema más frecuente es que el tratamiento no funciona tan bien como se esperaba. En un estudio con pacientes sometidos a prótesis de rodilla, solo el 33,7 % de quienes tenían niveles bajos alcanzaron niveles normales, incluso con suplementación en dosis medias o altas [1]. Administrar una dosis única elevada el día de la cirugía de prótesis de rodilla no influyó en la recuperación, en la rapidez con que los pacientes comenzaron a moverse ni en las tasas de complicaciones, en comparación con un placebo [2]. En cuanto a la reparación del manguito rotador, una revisión concluyó que no hay evidencia suficiente para justificar la suplementación en todos los pacientes [3].

También existen limitaciones respecto a lo que la vitamina D puede lograr. En mujeres posmenopáusicas con osteoporosis, la combinación de calcio y vitamina D mejoró la densidad ósea de la pelvis, pero no redujo el riesgo de fracturas [4]. El estado de vitamina D por sí solo quizá no influya en la recuperación inmediata tras la cirugía; no obstante, mantener niveles adecuados podría favorecer la supervivencia a largo plazo tras una cirugía de fractura de cadera [5].

Algunos resultados provienen de estudios en animales y no de ensayos clínicos en humanos, por lo que no se pueden aplicar directamente a usted [6]. La evidencia sobre la cicatrización de tendones se limita a un solo grupo de tendones y los estudios son de baja calidad [7]. Asimismo, no existen datos fiables sobre seguridad y eficacia de los suplementos peptídicos; por ello, no se recomiendan como sustituto ni complemento de la atención ortopédica estándar [8].

En resumen, vale la pena evaluar y tratar los niveles bajos de vitamina D, pero no constituye una solución garantizada. Su médico valorará la evidencia y su situación personal antes de recomendar este tratamiento.

¿Es adecuado para usted?

El tratamiento con vitamina D suele ser beneficioso para personas cuyos niveles son bajos y que van a someterse a cirugía o se están recuperando de una fractura. La suplementación regular disminuye el riesgo de deficiencia en pacientes sometidos a prótesis articulares durante el invierno [1]. Si sus niveles ya son adecuados, una suplementación en dosis bajas puede ayudar a mantenerlos así; en cambio, cuando los niveles son bajos, suelen ser necesarias dosis medias o altas para corregirlos [2]. Mantener niveles óptimos de vitamina D también podría mejorar la supervivencia a largo plazo tras una cirugía por fractura de cadera, aunque no influya en la recuperación inmediata [3].

Probablemente la vitamina D no sea adecuada para usted si sus niveles ya son normales y no tiene previsto ningún tratamiento, o si esperaba una mejora garantizada en la cicatrización. No sustituye la atención ortopédica estándar, y los suplementos de péptidos no deben emplearse en su lugar ni junto a ella, pues aún no existen datos fiables sobre su seguridad y eficacia [4]. Asimismo, los investigadores siguen desarrollando métodos más precisos para detectar lesiones y problemas de salud en atletas femeninas, lo cual debería permitir ofrecer mejores recomendaciones preventivas en el futuro [5].

La decisión final la tomará usted en conjunto con su médico. Este evaluará sus niveles, el tratamiento previsto y su estado de salud general, para luego determinar si resulta conveniente realizar análisis o iniciar una suplementación. Los posibles inconvenientes se detallan en la sección de riesgos anterior.

Conclusión

Vale la pena medir los niveles de vitamina D si va a someterse a una cirugía o se está recuperando de una fractura, ya que se pueden detectar mediante un análisis de sangre y tratarse. La suplementación regular disminuye el riesgo de deficiencia en pacientes sometidos a prótesis de articulaciones durante el invierno [1]. Si sus niveles ya son adecuados, una dosis baja puede mantenerlos así; en cambio, cuando los niveles son bajos suele ser necesario administrar dosis medias o altas para corregirlos [2]. Sea realista en sus expectativas: el tratamiento quizá no influya en su recuperación inmediata, aunque mantener niveles adecuados podría beneficiarle a largo plazo tras una cirugía por fractura de cadera [3]. Lo más importante es recordar que la vitamina D no constituye una solución infalible; actúa como complemento a la atención médica habitual, no como sustituto de ella.

Referencias

[1] El diagnóstico de deficiencia de vitamina D se asocia con tasas más elevadas de rotura del ligamento cruzado anterior y fracaso en la reconstrucción. Arthroscopy. 2023. DOI: 10.1016/j.arthro.2023.04.011

[2] La vitamina D y el riesgo de fracturas por estrés en atletas y personal militar: una revisión sistemática y metaanálisis. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465261441254

[3] Olvidar a los pacientes frágiles: tendencias nacionales en la prescripción de vitamina D tras una fractura por fragilidad; un estudio basado en una gran base de datos de reclamaciones de seguros. Journal of the American Academy of Orthopaedic Surgeons. 2024. DOI: 10.5435/jaaos-d-23-00932

[4] Efecto del nivel sérico de vitamina D en el proceso de cicatrización de heridas tras la cirugía abierta de liberación del túnel carpiano: resultados clínicos de 55 casos. Journal of the American Academy of Orthopaedic Surgeons. 2025. DOI: 10.5435/jaaos-d-25-00410

[5] La deficiencia de vitamina D se asocia con resultados médicos adversos tras la artroplastia total de hombro. JSES International. 2025. DOI: 10.1016/j.jseint.2025.01.010

[6] Impacto de la deficiencia de vitamina D en la mortalidad a corto y largo plazo en pacientes sometidos a cirugía de fractura de cadera bajo anestesia general: un estudio de cohorte emparejada. The Journal of Arthroplasty. 2025. DOI: 10.1016/j.arth.2025.04.080

[7] Papel de la vitamina D en la cicatrización tendinosa postoperatoria: una revisión de alcance. Orthopaedic Journal of Sports Medicine. 2025. DOI: 10.1177/23259671251371300

[8] Efecto de la suplementación con vitamina D en los resultados de la artroplastia total de rodilla: una revisión sistemática. Orthopaedic Journal of Sports Medicine. 2026. DOI: 10.1177/23259671261432670

[9] La deficiencia previa a la cirugía de vitamina D se asocia con mayor degeneración grasa del manguito rotador, pero es poco probable que influya en los resultados postoperatorios tras su reparación: una revisión sistemática y metaanálisis de coeficientes de correlación. JSES Reviews, Reports, and Techniques. 2025. DOI: 10.1016/j.xrrt.2025.02.006

[10] Efectos de la suplementación combinada con calcio y vitamina D en la densidad mineral ósea y el riesgo de fracturas en mujeres posmenopáusicas con osteoporosis: una revisión sistemática y metaanálisis de ensayos controlados aleatorizados. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-09089-7

[11] Suplementación con vitamina D3 previa a la artroplastia total de rodilla: un ensayo controlado aleatorizado. The Journal of Arthroplasty. 2023. DOI: 10.1016/j.arth.2022.08.020

[12] Efecto de una lámina de vitamina D basada en nanofibras para la cicatrización tendón- hueso y la regeneración muscular en un modelo de rotura del manguito rotador en conejos. Journal of Shoulder and Elbow Surgery. 2023. DOI: 10.1016/j.jse.2023.02.077

[13] La suplementación con vitamina D podría prevenir o tratar la deficiencia tras la artroplastia total de rodilla: un análisis retrospectivo de cohorte. Journal of the American Academy of Orthopaedic Surgeons. 2024. DOI: 10.5435/jaaos-d-24-00005

[14] Niveles de 25-hidroxivitamina D, calcio sérico libre, tasa de filtración glomerular, albúmina y mortalidad en pacientes ancianos con fractura de fémur. JAAOS: Global Research and Reviews. 2026. DOI: 10.5435/jaaosglobal-d-25-00108

[15] Suplementos peptídicos y sus aplicaciones terapéuticas en medicina deportiva. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465261464420

[16] Mayor prevalencia de deficiencia de vitamina D entre pacientes sometidos a artroplastia en invierno. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-06482-9

[17] Ámbitos de salud en atletas femeninas: suplemento a la declaración de consenso del Comité Olímpico Internacional sobre métodos para registrar e informar datos epidemiológicos sobre lesiones y enfermedades en el deporte. British Journal of Sports Medicine. 2023. DOI: 10.1136/bjsports-2022-106620


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 regarding the risk of stress fractures in athletes and military personnel [3].
  • 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].
  • 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].
  • 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 [7].
  • 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 [8].
  • 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 [25].

How It Works

Bone Health and Fracture Risk

  • 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 its importance for bone health in older adults needs to be raised [4].
  • Preoperative vitamin D screening and potential supplementation strategies are important for patients who have vitamin D levels below 20 ng/mL to address short- and long-term mortality risks after hip fracture surgery [8].
  • Active vitamin D3 treatment promoted fracture healing by affecting the levels of immune factors in osteoporotic fracture patients [17].

Tendon and Soft Tissue Healing

  • 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 [7].
  • Preoperative nonselective 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 [9].
  • 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 [19].
  • 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 [20].

Wound Healing and Infection

  • 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 [10].
  • 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 [12].

Immune Modulation and Other

  • 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].
  • Targeted interventions are needed to optimize musculoskeletal and metabolic health in adolescents with vitamin D deficiency and adverse body composition [13].

What the Evidence Shows

Fracture and Bone Health

  • 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].
  • Maintaining adequate vitamin D levels may improve longer-term survival after proximal femoral fracture surgery, although vitamin D status alone may not influence immediate recovery [22].

Arthroplasty and Joint Surgery

  • Preoperative vitamin D screening and potential supplementation strategies are important for patients with vitamin D levels below 20 ng/mL undergoing hip fracture surgery under general anesthesia [8].
  • Low-dose vitamin D supplementation was beneficial for vitamin D–sufficient total knee arthroplasty patients to achieve higher levels and maintain sufficiency [21].
  • Deficient total knee arthroplasty patients benefited from medium-to-high dose vitamin D supplementation, though only 33.7% achieved repletion [21].
  • Perioperative vitamin D supplementation may enhance early recovery and lower complication rates after total knee arthroplasty [23].
  • Supplementation with 50,000 international units of 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 patients [24].

Tendon and Soft Tissue Healing

  • Nonselective vitamin D supplementation appears to be more cost-effective than selective supplementation for arthroscopic rotator cuff repair, likely due to the lower cost of 25(OH)D supplementation compared to serum assays [9].

Other Musculoskeletal Conditions

Research Gaps and Limitations

  • 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 [8].
  • Vitamin D deficiency is associated with adverse medical outcomes following total shoulder arthroplasty [18].
  • Vitamin D deficiency is associated with increased rates of readmission and periprosthetic fractures following total shoulder arthroplasty [18].
  • Higher prevalence of vitamin D deficiency is observed among arthroplasty patients presenting in winter [6].

Supplementation and Management

  • Regular vitamin D supplementation significantly reduces the likelihood of deficiency [6].
  • Nonselective preoperative vitamin D supplementation appears to be more cost-effective than selective supplementation in arthroscopic rotator cuff repair [9].
  • The lower cost of 25(OH)D supplementation compared to serum assays likely contributes to the cost-effectiveness of nonselective preoperative supplementation in arthroscopic rotator cuff repair [9].

Evidence Limitations and Contraindications

  • Evidence suggests vitamin D may support tendon healing, particularly in rotator cuff repair, but studies remain low quality and limited to a single tendon group [7].
  • Peptide supplements should not currently be recommended as a replacement or adjunct for existing orthopaedic standard of care due to the lack of robust efficacy and safety data [11].

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)
  • [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. [7] (10.1177/23259671251371300)
  • [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. [8] (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. [9] (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. [10] (10.1016/j.arth.2024.05.012)
  • [L5] Because of the lack of robust efficacy and safety data, peptide supplements should not currently be recommended as a replacement or adjunct for existing orthopaedic standard of care. [11] (10.1177/03635465261464420)
  • [L3] Determining vitamin D levels preoperatively and providing supplementation if deficiency is present may be beneficial for preventing delayed wound healing. [12] (10.5435/jaaos-d-25-00410)
  • [L3] These findings highlight the need for targeted interventions to optimize musculoskeletal and metabolic health during this developmental window. [13] (10.1186/s13018-025-06091-6)
  • [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] Active vitamin D3 treatment promoted fracture healing by affecting the levels of these immune factors. [17] (10.1186/s13018-023-03777-7)
  • [L3] The observed association between vitamin D deficiency and increased rates of readmission and periprosthetic fractures suggests that addressing vitamin D levels may be linked to reduced future healthcare utilization. [18] (10.1016/j.jseint.2025.01.010)
  • [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. [19] (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. [20] (10.5397/cise.2024.00220)
  • [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. [21] (10.5435/jaaos-d-24-00005)
  • [L2] Although vitamin D status alone may not influence immediate recovery, maintaining adequate levels may improve longer term survival after PFF surgery. [22] (10.5435/jaaosglobal-d-25-00108)
  • [L2] Our study demonstrated that perioperative vitamin D supplementation may enhance early recovery and lower complication rates after TKA. [23] (10.1177/23259671261432670)
  • [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. [24] (10.1016/j.arth.2022.08.020)
  • [L4] These parameters might be considered diagnostic non-invasive predictors of bone health for clinical use in epidemiological contexts. [25] (10.1186/s12891-023-06960-3)

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

[4] 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

[5] Prevalence of Vitamin D Deficiency in Patients With Charcot Arthropathy: A Single-Center Analysis. JAAOS: Global Research and Reviews. 2022. DOI: 10.5435/jaaosglobal-d-22-00162

[6] 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

[7] The Role of Vitamin D in Postoperative Tendon Healing: A Scoping Review. Orthopaedic Journal of Sports Medicine. 2025. DOI: 10.1177/23259671251371300

[8] 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

[9] Preoperative vitamin D supplementation is a cost-effective intervention in arthroscopic rotator cuff repair. Journal of Shoulder and Elbow Surgery. 2023. DOI: 10.1016/j.jse.2023.05.007

[10] Effect of Vitamin D Deficiency on Periprosthetic Joint Infection and Complications After Primary Total Joint Arthroplasty. The Journal of Arthroplasty. 2024. DOI: 10.1016/j.arth.2024.05.012

[11] Peptide Supplements and Their Therapeutic Applications in Sports Medicine. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465261464420

[12] 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

[13] Vitamin D deficiency and adverse body composition in adolescents. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-06091-6

[15] Randomized controlled trial of vitamin d supplementation on toll-like receptor-2 (tlr-2) and toll-like receptor-4 (tlr-4) in tuberculosis spondylitis patients. Journal of Orthopaedic Surgery and Research. 2023. DOI: 10.1186/s13018-023-04445-6

[16] 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

[17] 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

[18] Vitamin D deficiency is associated with adverse medical outcomes following total shoulder arthroplasty. JSES International. 2025. DOI: 10.1016/j.jseint.2025.01.010

[19] Localized vitamin D delivery via 3D-printed nanofiber sheets combined with systemic supplementation enhances tendon-to-bone healing in a rabbit rotator cuff tear model: a preclinical study. Journal of Shoulder and Elbow Surgery. 2026. DOI: 10.1016/j.jse.2025.12.003

[20] The role of vitamin D in shoulder health: a comprehensive review of its impact on rotator cuff tears and surgical results. Clinics in Shoulder and Elbow. 2024. DOI: 10.5397/cise.2024.00220

[21] 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

[22] 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

[23] Effect of Vitamin D Supplementation on Total Knee Arthroplasty Outcomes: A Systematic Review. Orthopaedic Journal of Sports Medicine. 2026. DOI: 10.1177/23259671261432670

[24] 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

[25] Hand grip strength, vitamin D status, and diets as predictors of bone health in 6–12 years old school children. BMC Musculoskeletal Disorders. 2023. DOI: 10.1186/s12891-023-06960-3

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