Effect of vitamin D on anterior cruciate ligament injury rates and post‐reconstruction function—A systematic review

Abstract Purpose This systematic review aimed to investigate the association between serum vitamin D levels and key outcomes following anterior cruciate ligament reconstruction (ACLR), including ACL injury risk, postoperative muscle recovery and post‐reconstruction functional outcomes. Methods We co...

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Main Authors: Andrea Pasquini, Radu Prejbeanu, Octav Russu, Riccardo D'Ambrosi, Cosmin Ioan Faur, Giulio Maria Marcheggiani Muccioli, Mihail Lazar Mioc
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:Journal of Experimental Orthopaedics
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Online Access:https://doi.org/10.1002/jeo2.70224
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author Andrea Pasquini
Radu Prejbeanu
Octav Russu
Riccardo D'Ambrosi
Cosmin Ioan Faur
Giulio Maria Marcheggiani Muccioli
Mihail Lazar Mioc
author_facet Andrea Pasquini
Radu Prejbeanu
Octav Russu
Riccardo D'Ambrosi
Cosmin Ioan Faur
Giulio Maria Marcheggiani Muccioli
Mihail Lazar Mioc
author_sort Andrea Pasquini
collection DOAJ
description Abstract Purpose This systematic review aimed to investigate the association between serum vitamin D levels and key outcomes following anterior cruciate ligament reconstruction (ACLR), including ACL injury risk, postoperative muscle recovery and post‐reconstruction functional outcomes. Methods We conducted a comprehensive search across five databases (Cochrane Library, EMBASE, MEDLINE, Scopus and Web of Science) until July 2024. Studies were selected based on specific inclusion criteria, such as studies evaluating the relationship between vitamin D and injury risk, ACLR outcomes and muscle strength. Risk of bias was assessed using the MINORS tool, and results were synthesized narratively due to study heterogeneity. Results Five studies with 656,243 participants met the inclusion criteria. Most studies reported that low vitamin D levels were associated with a significantly increased risk of ACL injuries and poorer postoperative muscle strength recovery. However, evidence regarding bone health and functional outcomes was inconsistent. No meta‐analysis was conducted due to the variability of study designs and outcomes, but qualitative synthesis indicated a potential protective role of vitamin D in ACL recovery. Conclusions Vitamin D deficiency appears to increase the risk of ACL injury and impede muscle recovery post‐surgery. However, limitations include a high risk of bias and inconsistent evidence on functional outcomes, underscoring the need for further research. The review was registered in PROSPERO (ID: CRD42024584483). Level of Evidence Level III, systematic review.
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spelling doaj-art-b6b3a8d69b18483eb831e1e27838a0e82025-08-20T03:46:57ZengWileyJournal of Experimental Orthopaedics2197-11532025-04-01122n/an/a10.1002/jeo2.70224Effect of vitamin D on anterior cruciate ligament injury rates and post‐reconstruction function—A systematic reviewAndrea Pasquini0Radu Prejbeanu1Octav Russu2Riccardo D'Ambrosi3Cosmin Ioan Faur4Giulio Maria Marcheggiani Muccioli5Mihail Lazar Mioc6Department of Orthopaedics and Traumatology “Pius Brinzeu” Emergency Clinical County Hospital Timisoara RomaniaDepartment XV‐Discipline of Orthopedics‐Traumatology “Victor Babes” University of Medicine and Pharmacy Timisoara RomaniaUMFST G.E. Palade Tg. Mures Târgu Mureș RomaniaIRCCS Istituto Ortopedico Galeazzi Milan ItalyDepartment XV‐Discipline of Orthopedics‐Traumatology “Victor Babes” University of Medicine and Pharmacy Timisoara RomaniaII Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli Bologna ItalyDepartment XV‐Discipline of Orthopedics‐Traumatology “Victor Babes” University of Medicine and Pharmacy Timisoara RomaniaAbstract Purpose This systematic review aimed to investigate the association between serum vitamin D levels and key outcomes following anterior cruciate ligament reconstruction (ACLR), including ACL injury risk, postoperative muscle recovery and post‐reconstruction functional outcomes. Methods We conducted a comprehensive search across five databases (Cochrane Library, EMBASE, MEDLINE, Scopus and Web of Science) until July 2024. Studies were selected based on specific inclusion criteria, such as studies evaluating the relationship between vitamin D and injury risk, ACLR outcomes and muscle strength. Risk of bias was assessed using the MINORS tool, and results were synthesized narratively due to study heterogeneity. Results Five studies with 656,243 participants met the inclusion criteria. Most studies reported that low vitamin D levels were associated with a significantly increased risk of ACL injuries and poorer postoperative muscle strength recovery. However, evidence regarding bone health and functional outcomes was inconsistent. No meta‐analysis was conducted due to the variability of study designs and outcomes, but qualitative synthesis indicated a potential protective role of vitamin D in ACL recovery. Conclusions Vitamin D deficiency appears to increase the risk of ACL injury and impede muscle recovery post‐surgery. However, limitations include a high risk of bias and inconsistent evidence on functional outcomes, underscoring the need for further research. The review was registered in PROSPERO (ID: CRD42024584483). Level of Evidence Level III, systematic review.https://doi.org/10.1002/jeo2.70224anterior cruciate ligament (ACL)anterior cruciate ligament injuryanterior cruciate ligament reconstruction (ACLR)functional outcomemuscle strengthserum vitamin D level
spellingShingle Andrea Pasquini
Radu Prejbeanu
Octav Russu
Riccardo D'Ambrosi
Cosmin Ioan Faur
Giulio Maria Marcheggiani Muccioli
Mihail Lazar Mioc
Effect of vitamin D on anterior cruciate ligament injury rates and post‐reconstruction function—A systematic review
Journal of Experimental Orthopaedics
anterior cruciate ligament (ACL)
anterior cruciate ligament injury
anterior cruciate ligament reconstruction (ACLR)
functional outcome
muscle strength
serum vitamin D level
title Effect of vitamin D on anterior cruciate ligament injury rates and post‐reconstruction function—A systematic review
title_full Effect of vitamin D on anterior cruciate ligament injury rates and post‐reconstruction function—A systematic review
title_fullStr Effect of vitamin D on anterior cruciate ligament injury rates and post‐reconstruction function—A systematic review
title_full_unstemmed Effect of vitamin D on anterior cruciate ligament injury rates and post‐reconstruction function—A systematic review
title_short Effect of vitamin D on anterior cruciate ligament injury rates and post‐reconstruction function—A systematic review
title_sort effect of vitamin d on anterior cruciate ligament injury rates and post reconstruction function a systematic review
topic anterior cruciate ligament (ACL)
anterior cruciate ligament injury
anterior cruciate ligament reconstruction (ACLR)
functional outcome
muscle strength
serum vitamin D level
url https://doi.org/10.1002/jeo2.70224
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