SynthesisBMC musculoskeletal disorders2025
The impact of vitamin C supplementation on the perioperative outcomes after total hip and knee arthroplasty: a systematic review and meta-analysis.
Synthesis in BMC musculoskeletal disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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9 authors.
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Abstract
backgroundThe perioperative efficacy of vitamin C (VC) supplementation in total hip and knee arthroplasty (THA/TKA) remains underexplored. This systematic review and meta-analysis comprehensively evaluated, for the first time, the impact of VC on perioperative outcomes in THA/TKA.
methodsIn accordance with the PRISMA guidelines and prospectively registered with PROSPERO, we searched PubMed, Web of Science, Embase, and the Cochrane Library databases up to April 30, 2025. Two independent investigators performed literature screening, data extraction, and Cochrane risk-of-bias assessments. Meta-analyses were conducted using RevMan 5.4 software, and qualitative synthesis was applied where appropriate.
resultsEight RCTs involving 852 patients were included. Meta-analysis revealed that, compared to controls, VC supplementation significantly reduced postoperative 24-hour visual analog scale (VAS) scores (MD = -0.60, 95% CI -1.14 to -0.07), C-reactive protein (CRP) levels (MD = -14.88, 95% CI -16.84 to -12.92), and interleukin-6 (IL-6) levels (MD = -9.17, 95% CI -12.94 to -5.41). However, no significant differences were observed in these outcomes at 48 h postoperatively (P > 0.05). Qualitative analysis suggested that perioperative VC supplementation may decrease the risk of complex regional pain syndrome (CRPS) and bleeding, reduce propofol dosage, lower the incidence of nausea, and potentially protect against cardiac issues and arthrofibrosis development.
conclusionPerioperative VC supplementation for THA/TKA may alleviate pain and reduce inflammatory responses within 24 h. Large-scale, high-quality RCTs employing standardized VC protocols are required in the future to establish reliable evidence-based foundations for clinical implementation.
trial registrationThis study was prospectively registered in the PROSPERO database (registration number: CRD42025633608) on January 17, 2025.
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