Vitamin D at Kalusugan ng Musculoskeletal Impormasyon

Ano ito

Ang bitamina D ay isang sustansya na tumutulong sa iyong katawan na gamitin ang kalsiyum upang panatilihing matibay ang mga buto. Naglalarun ito rin ng papel sa pag-andar ng kalamnan at paggaling. Maaaring suriin ng iyong doktor ang antas ng bitamina D bago ang operasyon upang matiyak na handa ang iyong katawan para sa paggaling. Mahalaga ito lalo na kung ikaw ay gagampanan ang operasyon para sa fracture ng balikat o palitan ng kasukasuan.

Ang mababang antas ng bitamina D ay nauugnay sa mas mataas na panganib ng pinsala sa buto. Halimbawa, ang kakulangan ay may kinalaman sa pagtaas ng tsansang masira ang anterior cruciate ligament at mabigo ang rekonstruksyon. Nauugnay din ito sa stress fractures sa mga atleta at miyembro ng militar. Sa mga nakatatanda, mas karaniwan ang kakulangan noong taglamig at maaari nitong maapektuhan ang kalusugan ng buto. Ang pag-screening para sa kakulangan ay tumutulong upang gabayan ang mga estratehiya ng pag-iwas para sa mga grupong ito.

Maaaring suportahan ng bitamina D ang paggaling ng tendon, lalo na sa rotator cuff repair. Ang ebidensya para dito ay kasalukuyang mababa ang kalidad at limitado sa isang grupo ng tendon. Gayunpaman, ang pagwawasto ng kakulangan bago ang operasyon ay maaaring tumulong upang maiwasan ang pagkaantala sa paggaling ng sugat. Ang pagbibigay ng isang malaking dosis ng bitamina D bago ang palitan ng kasukasuan ay maaaring magkaroon ng positibong epekto sa mga resulta. Ang aktibong paggamot ng bitamina D3 ay nagpapaigding din sa paggaling ng fracture sa pamamagitan ng pag-apekto sa mga immune factor sa katawan.

Maaaring irekomenda ng iyong doktor ang pag-screening kung ang antas ng bitamina D ay nasa ilalim ng 20 ng/mL. Ito ay karaniwan sa mga pasyenteng nasa ilalim ng general anesthesia para sa operasyon ng fracture ng balikat. Para sa arthroscopic rotator cuff repair, ang nonselective supplementation ay madalas na mas cost-effective kaysa sa pagsusuri sa lahat bago ang pagbibigay ng supplements. Ang pamamaraang ito ay nakakatipid sa pera para sa mga blood test habang pinipagtibay na nakakakuha ang mga pasyente ng mga sustansyang kailangan nila. Ang regular na supplementation ay malaki ang pagbaba sa tsansang magkaroon ng kakulangan sa mga pasyenteng nasa ilalim ng arthroplasty.

Sa mga bata, ang lakas ng hawak ng kamay, kalagayan ng bitamina D, at diyeta ay mga predictor ng kalusugan ng buto. Ang mga targeted na interbensyon ay maaaring i-optimize ang musculoskeletal at metabolic health sa mga adolescent. Para sa karamihan ng mga pasyente, ang pagpapanatili ng sapat na antas ng bitamina D ay sumusuporta sa pangkalahatang musculoskeletal health at paggaling.

Gumagana ba ito?

Hindi pare-pareho ang ebidensya tungkol sa bitamina D. Malinaw na nakakatulong ito upang ayusin ang mababang antas sa iyong dugo. Maaari rin nitong suportahan ang lakas ng buto at paggaling pagkatapos ng ilang uri ng operasyon. Gayunpaman, hindi ito kamangha-manghang gamot para sa lahat ng sugat o sakit.

Para sa mga pasyenteng may joint replacement, may malinaw na papel ang bitamina D. Kung mababa ang iyong antas bago ang operasyon, maaaring irekomenda ng iyong doktor ang mga supplement upang matulungan ang iyong katawan na gumaling. Ilang pag-aaral ang nagpapakita na ang pagwawasto ng kakulangan bago ang total knee o hip replacement ay maaaring mapabuti ang maagang paggaling at bawasan ang mga komplikasyon. Isang pamamaraan ay isang malaking dosis na 300,000 U upang mabilis na ayusin ang kakulangan. Maaari nitong positibong epektohin ang mga resulta pagkatapos ng primary total joint replacement. Isang pag-aaral naman ang nakahanap na ang pagbibigay ng 50,000 international units sa araw ng operasyon ay hindi malaki ang pagbabago sa maagang pag-andar o mga komplikasyon kumpara sa placebo. Kaya, mahalaga ang timing at dosage.

Ang bitamina D ay may kaugnayan din sa kalusugan ng buto sa ibang paraan. Ang regular na suplementasyon ay nagbabawas ng posibilidad ng kakulangan sa mga pasyenteng may joint replacement. Para sa mga may osteoporosis, ang pagkombina ng bitamina D sa high-intensity interval training ay nag-aalok ng mas malaking benepisyo para sa bone density kaysa sa isa-isa. Sa mga adolescents, ang kakulangan ay may kaugnayan sa masamang komposisyon ng katawan, kaya mahalaga ang mga target na interbensyon. Para sa mga nakatatanda, mababa pa rin ang kamalayan sa pangangailangan ng bitamina D pagkatapos ng fragility fractures, bagama't umuunlad ang mga gabay.

Mas hindi sigurado ang pag-iwas sa sugat. Bagama't ang mababang bitamina D ay may kaugnayan sa mas mataas na panganib ng anterior cruciate ligament tears at stress fractures, kailangan pa ng higit pang pananaliksik upang kumpirmahin kung ang mga supplement ay nakakapag-iwas sa mga sugat na ito sa mga atleta. limitado ang ebidensya para sa paggaling ng tendon, tulad sa rotator cuff repairs, at mababa ang kalidad nito. Maaari itong tumulong, pero kailangan pa natin ng higit pang pag-aaral upang maging sigurado.

Sa kabuuan, ang pag-check ng iyong antas ng bitamina D ay isang matalinong hakbang. Nakakatulong ito upang maibigay ng iyong doktor ang isang plano na angkop sa iyo. Depende kung kailangan mo ng maliit na araw-araw na dosis o mas malaking corrective dose sa iyong partikular na pangangailangan at sa operasyon na iyong gagawin.

Tama ba ito para sa iyo?

Maaari kang makikinabang sa pagsusuri ng iyong antas ng bitamina D kung ikaw ay isang atleta, miyembro ng militar, o matandang tao. Ang mababang antas ay nauugnay sa mas mataas na panganib ng pagputol ng ligamento ng tuhod at stress fractures. Maaaring irekomenda ng iyong doktor ang pagsusuri bago ang operasyon ng pagpapalit ng balikat o tuhod. Ito ay lalo na kung ikaw ay gagawa ng operasyon sa taglamig o may kasaysayan ng fragility fractures. Ang pagwawasto ng kakulangan bago ang pagpapalit ng kasu-kasuan ay makakatulong sa iyong katawan na gumaling nang mas mabuti.

Kung ikaw ay gagawa ng rotator cuff repair o carpal tunnel release, maaaring suriin ng iyong doktor ang iyong mga antas upang maiwasan ang mabagal na paggaling ng sugat. Para sa mga pasyente ng pagpapalit ng tuhod, ang pag-inom ng bitamina D ay tumutulong upang mapanatili ang mga malusog na antas. Gayunpaman, 33.7% lamang ng mga pasyenteng may kakulangan ang nakarating sa mga malusog na antas gamit ang pamantayang medium-to-high dose na supplements. Maaaring kailanganin mo ang isang malaking dosis na 300,000 U upang mabilis na ayusin ang kakulangan. Ang paraang ito ay maaaring mapabuti ang mga resulta pagkatapos ng primary total joint replacement.

Hindi mo malamang makikita ang malalaking benepisyo kung ikaw ay isang malusog na elite athlete na walang kilalang kakulangan. Kailangan pa ng karagdagang pananaliksik upang patunayan na binabawasan ng mga supplements ang panganib ng pinsala sa grupong ito. Bukod dito, habang tumutulong ang ehersisyo at bitamina D nang sabay sa bone density ng mga kababaihan na may osteoporosis, limitado pa rin ang ebidensya para sa paggaling ng tendon.

Ang pangunahing downside ay maaaring hindi ganap na wawasto ang mga supplements sa isang malubhang kakulangan nang mag-isa. Madalas na mas cost-effective ang pagbibigay ng supplements sa lahat kaysa sa pagsusuri sa lahat muna, dahil mas murang ang mga tabletang ito kaysa sa mga blood test. Makipag-usap sa iyong doktor kung ang pagsusuri o direktang suplementasyon ang angkop para sa iyong partikular na sitwasyon.

Ang pangunahing aral

Maaaring suriin ng iyong doktor ang antas ng vitamin D bago ang operasyon upang matulungan ang iyong mga buto at paggaling. Ang pag-inom ng mga supplement ay maaaring bawasan ang panganib ng mga komplikasyon at mapabuti ang paggaling pagkatapos ng joint replacement. Gayunpaman, magkakaiba ang mga resulta. Tanging 33.7% lamang ng mga pasyenteng may kakulangan ang nakarating sa malusog na antas gamit ang karaniwang dosis. Kailangan pa ng karagdagang pananaliksik upang kumpirmahin ang mga benepisyo para sa mga atleta at mga pag-aayos ng tendon. Tanungin ang iyong doktor kung ang pagsubok o suplementasyon ay angkop para sa iyo.

Evidence & references

Overview

Vitamin D supplementation effects on bone health and injury risk in elite athletes require further research [1].
A diagnosis of vitamin D deficiency is associated with increased odds of anterior cruciate ligament tears and reconstruction failure [2].
Vitamin D status should be assessed in high-risk populations, such as athletes and military personnel, to guide preventive strategies for stress fractures [3].
Educational initiatives and revised guidelines may have improved vitamin D prescription rates after fragility fracture, but awareness remains needed for older adults [4].
Vitamin D deficiency prevalence is higher among arthroplasty patients presenting in winter [5].
Regular vitamin D supplementation significantly reduces the likelihood of deficiency in arthroplasty patients [5].
Evidence suggests vitamin D may support tendon healing, particularly in rotator cuff repair, but studies are low quality and limited to a single tendon group [6].
Vitamin D deficiency is associated with adverse body composition in adolescents [7].
Targeted interventions are needed to optimize musculoskeletal and metabolic health in adolescents regarding vitamin D status [7].
Preoperative vitamin D screening and potential supplementation strategies are important for patients receiving hip fracture surgery under general anesthesia who have vitamin D levels below 20 ng/mL [8].
Preoperative vitamin D supplementation is a cost-effective intervention in arthroscopic rotator cuff repair [9].
Nonselective vitamin D supplementation appears more cost-effective than selective supplementation in arthroscopic rotator cuff repair due to lower costs compared to serum assays [9].
Hand grip strength, vitamin D status, and diets are predictors of bone health in 6–12 year old school children [23].
Hand grip strength, vitamin D status, and diets might be considered diagnostic non-invasive predictors of bone health for clinical use in epidemiological contexts [23].

How It Works

Vitamin D supplementation effects on bone health and injury risk in elite athletes require further research [1].
Vitamin D deficiency is associated with increased odds of anterior cruciate ligament tears and reconstruction failure [2].
Vitamin D status assessment in high-risk populations (athletes and military personnel) guides preventive strategies for stress fractures [3].
Educational initiatives and revised guidelines may have improved vitamin D prescription rates after fragility fracture, but awareness remains needed for older adults [4].
Regular vitamin D supplementation significantly reduces the likelihood of deficiency in arthroplasty patients presenting in winter [5].
Vitamin D may support tendon healing, particularly in rotator cuff repair, though evidence is low quality and limited to a single tendon group [6].
Vitamin D deficiency is associated with adverse body composition in adolescents, highlighting the need for targeted interventions during development [7].
Preoperative vitamin D screening and potential supplementation are important for patients receiving hip fracture surgery under general anesthesia with levels below 20 ng/mL [8].
Nonselective preoperative vitamin D supplementation is more cost-effective than selective supplementation in arthroscopic rotator cuff repair due to lower costs compared to serum assays [9].
Determining preoperative vitamin D levels and providing supplementation if deficient may be beneficial for preventing delayed wound healing after open carpal tunnel release surgery [10].
Administering an oral 300,000 U single-dose vitamin D regimen to correct deficiency can positively impact outcomes following primary total joint arthroplasty [11].
Further research is necessary to elucidate the direct role of vitamin D in rotator cuff tear pathogenesis and its impact on clinical outcomes after rotator cuff surgery and total shoulder arthroplasty [12].
A nanofiber-based vitamin D sheet was compared to vitamin D supplementation for tendon-to-bone healing and muscle regeneration in a rabbit rotator cuff tear model [13].
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 [14].
Active vitamin D3 treatment promoted fracture healing by affecting immune factor levels in osteoporotic fracture patients [17].
Combining systemic and localized vitamin D delivery via 3D-printed nanofiber sheets significantly enhanced tendon-to-bone healing, muscle regeneration, and biomechanical strength in a rabbit rotator cuff tear model compared to other treatment groups [19].

What the Evidence Shows

Vitamin D supplementation effects on bone health and injury risk in elite athletes require further research [1].
A diagnosis of vitamin D deficiency is associated with increased odds of anterior cruciate ligament tears and reconstruction failure [2].
Vitamin D status should be assessed in high-risk populations, such as athletes and military personnel, to guide preventive strategies for stress fractures [3].
Educational initiatives and revised guidelines may have improved vitamin D prescription rates after fragility fracture, but awareness remains low in older adults [4].
Vitamin D deficiency is more prevalent among arthroplasty patients presenting in winter [5].
Regular vitamin D supplementation significantly reduces the likelihood of vitamin D deficiency [5].
Vitamin D deficiency is associated with adverse body composition in adolescents [7].
Targeted interventions are needed to optimize musculoskeletal and metabolic health in adolescents regarding vitamin D status [7].
Preoperative vitamin D screening and potential supplementation are important for patients with vitamin D levels below 20 ng/mL undergoing hip fracture surgery under general anesthesia [8].
Vitamin D deficiency is associated with increased short- and long-term mortality in patients receiving hip fracture surgery under general anesthesia [8].
Nonselective preoperative vitamin D supplementation is more cost-effective than selective supplementation in arthroscopic rotator cuff repair, likely due to lower costs compared to serum assays [9].
Determining preoperative vitamin D levels and providing supplementation if deficiency is present may be beneficial for preventing delayed wound healing after open carpal tunnel release surgery [10].
Administering an oral 300,000 U single-dose vitamin D regimen to correct deficiency can positively impact outcomes following primary total joint arthroplasty [11].
Vitamin D deficiency is associated with increased risk of periprosthetic joint infection and complications after primary total joint arthroplasty [11].
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 [12].
Vitamin D may support tendon healing, particularly in rotator cuff repair, but current studies are low quality and limited to a single tendon group [6].
Supplementation with vitamin D 10,000 IU/day for 8 weeks can increase vitamin D levels to >50 ng/dl to optimally act as an immunomodulator in tuberculosis spondylitis patients [14].
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 intervention alone [15].
Low-dose vitamin D supplementation was beneficial for vitamin D–sufficient total knee arthroplasty patients to achieve higher levels and maintain sufficiency [16].
Deficient total knee arthroplasty patients benefited from medium-to-high dose vitamin D supplementation, though only 33.7% achieved repletion [16].
Perioperative vitamin D supplementation may enhance early recovery and lower complication rates after total knee arthroplasty [20].
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 [21].
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 [22].

Practical Considerations

Vitamin D supplementation effects on bone health and injury risk in elite athletes require further research [1].
A diagnosis of vitamin D deficiency is associated with increased odds of anterior cruciate ligament tears and reconstruction failure [2].
Vitamin D status should be assessed in high-risk populations, such as athletes and military personnel, to guide preventive strategies for stress fractures [3].
Educational initiatives and revised guidelines may have improved vitamin D prescription rates after fragility fracture, but awareness remains a need, particularly in older adults [4].
Regular vitamin D supplementation significantly reduces the likelihood of vitamin D deficiency in arthroplasty patients presenting in winter [5].
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 [6].
Vitamin D deficiency is associated with adverse body composition in adolescents, highlighting the need for targeted interventions to optimize musculoskeletal and metabolic health during this developmental window [7].
Preoperative vitamin D screening and potential supplementation strategies are important for patients receiving hip fracture surgery under general anesthesia who have vitamin D levels below 20 ng/mL [8].
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 [9].
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 [10].
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 [11].
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 intervention alone [15].
Low-dose vitamin D supplementation was beneficial for vitamin D–sufficient total knee arthroplasty patients to achieve higher levels and maintain sufficiency, while deficient patients benefitted from medium-to-high dose supplementation [16].
Only 33.7% of vitamin D–deficient total knee arthroplasty patients achieved repletion with medium-to-high dose supplementation [16].
Vitamin D deficiency is associated with adverse medical outcomes following total shoulder arthroplasty, including increased rates of readmission and periprosthetic fractures [18].

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)
[L3] Regular vitamin D supplementation significantly reduces the likelihood of deficiency. [5] (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. [6] (10.1177/23259671251371300)
[L3] These findings highlight the need for targeted interventions to optimize musculoskeletal and metabolic health during this developmental window. [7] (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. [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] Determining vitamin D levels preoperatively and providing supplementation if deficiency is present may be beneficial for preventing delayed wound healing. [10] (10.5435/jaaos-d-25-00410)
[L3] Administering an oral 300,000 U single-dose vitamin D regimen to correct vitamin D deficiency can positively impact outcomes following primary TJA. [11] (10.1016/j.arth.2024.05.012)
[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. [12] (10.5397/cise.2024.00220)
[L5] The study aimed to compare the efficacy of a nanofiber-based vitamin D sheet versus vitamin D supplementation on tendon-to-bone healing and muscle regeneration in a rabbit model, though specific conclusion statements were not fully provided in the text. [13] (10.1016/j.jse.2023.02.077)
[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. [14] (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. [15] (10.1186/s12891-025-08275-x)
[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. [16] (10.5435/jaaos-d-24-00005)
[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)
[L2] Our study demonstrated that perioperative vitamin D supplementation may enhance early recovery and lower complication rates after TKA. [20] (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. [21] (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. [22] (10.1186/s12891-023-06896-8)
[L4] These parameters might be considered diagnostic non-invasive predictors of bone health for clinical use in epidemiological contexts. [23] (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] 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 [6] The Role of Vitamin D in Postoperative Tendon Healing: A Scoping Review. Orthopaedic Journal of Sports Medicine. 2025. DOI: 10.1177/23259671251371300 [7] Vitamin D deficiency and adverse body composition in adolescents. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-06091-6 [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] 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 [11] 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 [12] 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 [13] The Effect Of Nanofiber-Based Vitamin D Sheet For Tendon-To-Bone Healing And Muscle Regeneration In A Rabbit Rotator Cuff Tear Model. Journal of Shoulder and Elbow Surgery. 2023. DOI: 10.1016/j.jse.2023.02.077 [14] 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 [15] 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 [16] 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 [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] Effect of Vitamin D Supplementation on Total Knee Arthroplasty Outcomes: A Systematic Review. Orthopaedic Journal of Sports Medicine. 2026. DOI: 10.1177/23259671261432670 [21] 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 [22] Regular sling core stabilization training improves bone density based on calcium and vitamin D supplementation. BMC Musculoskeletal Disorders. 2023. DOI: 10.1186/s12891-023-06896-8 [23] 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