A prospective study on 153 athletes that underwent ACL surgery looked at this very question. Interestingly, the authors concluded that vitamin D status has no effect on outcomes, yet those with the lowest vitamin D status had three times the failure rate than those with higher vitamin D, meaning the authors’ conclusion is not the only conclusion at which one may arrive. Here are the details...
The average age of the 153 patients was around 24 years old – young, healthy athletes. All 153 patients enrolled in this study underwent ACL surgery. The ACL (anterior cruciate ligament) is a cross-shaped ligament that connects bones around the knee and is a common location of injury for many athletes. Each of the patients in this study had their vitamin measured pre-operatively and were grouped accordingly based on their vitamin D status:
Group 1 – vitamin D below 20 ng/mL (commonly considered deficient)
Group 2 – vitamin D between 20-30 ng/mL (commonly considered low but technically “in range”)
Group 3 – vitamin D above 30 ng/mL (commonly considered sufficient, but not necessarily optimal)
All the patients were followed for 2 years and their ACL surgical recovery was quantified with two scoring systems:
The Lysholm score – this is a 100 point scoring system that looks at a person’s knee-specific function including mechanical locking, instability, pain, swelling, stair climbing and squatting.
The WOMAC score – this is a scoring system that measures physical function, pain and stiffness in knee and hip replacements. WOMAC stands for Western Ontario and McMasters Universities Osteoarthritis Index.
After 2 years, the Lysholm score for each group was about the same (96, 96.5 and 97) and their WOMAC scores were also similar (3.3, 3.4, 3.2). However, a difference was seen in the graft failure rate which was about 6% in Group 1 (lowest vitamin D) and about 2% in Group 2 and 3.
This shows that the lowest vitamin D status has three times the graft failure compared with patients who had better vitamin D levels, suggesting that perhaps vitamin D – a known anti-inflammatory nutrient with countless metabolic functions that are superbly documented in the medical literature – does improve surgical success and recovery in young, healthy athletes.
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Source: (European Journal of Orthopedic Surgery and Traumatology, January 2021)
