The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

The Impact of Vitamin D Supplementation on Postoperative Outcomes Following Total Joint Arthroplasty: A Systematic Review

Document Type : SYSTEMATIC REVIEW

Authors
Ali Salmani 1
Yashar Khani 2
Negarsadat Namazi 2
Sadra Mohebbi 3
Negin Ashoori 4
Amir Mehrvar 5
1 Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2 Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
4 Department of Medicine, Ardabil branch, Islamic Azad University, Ardabil, Iran
5 Clinical Research Development Units, Taleghani Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran
10.22038/abjs.2026.89311.4049
Abstract
Objectives: This systematic review examines the effects of vitamin D supplementation on postoperative outcomes following total knee and hip arthroplasty, taking into account its role in musculoskeletal health and the high prevalence of vitamin D deficiency among arthroplasty patients.
Methods: A comprehensive search of PubMed, Scopus, Embase, and Web of Science was conducted through April 2026. Eligible studies included randomized clinical trials assessing vitamin D supplementation in patients undergoing total knee or hip arthroplasty. Two reviewers independently screened studies, extracted data, and evaluated methodological quality using the Cochrane RoB-2 tool. Due to substantial methodological heterogeneity, a qualitative synthesis was performed.
Results: Five randomized controlled trials comprising 519 patients were included. Higher-dose and oral regimens resulted in greater increases in serum 25(OH)D levels, including higher postoperative concentrations with 2000 IU versus 800 IU at 24 months (45.5 vs. 37.1 ng/mL) and with oral versus intramuscular administration of 600,000 IU on postoperative day 14. However, most studies reported no significant between-group differences in functional outcomes, pain scores, complications, or other clinical endpoints. One study demonstrated significantly greater muscle strength in the supplementation group, including hip abductor strength (P = 0.03) and knee extensor strength (P = 0.01).
Conclusion: Vitamin D supplementation appears to improve perioperative vitamin D status, particularly with higher-dose and oral regimens. However, current evidence for consistent benefits on broader postoperative functional and clinical outcomes after joint arthroplasty remains limited and inconclusive.
Level of evidence: II
Keywords
Supplementation
Total hip arthroplasty
Total knee arthroplasty
Vitamin D
Subjects
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The Archives of Bone and Joint Surgery
Volume 14, Issue 9
September 2026
Pages 571-580

  • Receive Date 10 November 2025
  • Revise Date 23 May 2026
  • Accept Date 24 May 2026