विटामिन डी और मस्कुलोस्केलेटल स्वास्थ्य

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