Perioperative Vitamin C supplementation for knee and hip arthroplasty alleviate pain and reduce inflammatory responses within 24 h.: study

Written By : Dr Supreeth D R Published On 2025-10-15T20:30:38+05:30 | Updated On 15 Oct 2025 8:30 PM IST

The perioperative efficacy of vitamin C (VC) supplementation in total hip and knee arthroplasty (THA/ TKA) remains underexplored. The systematic review and meta-analysis by Liu et al comprehensively evaluated the impact of VC on perioperative outcomes in THA/TKA.

In accordance with the PRISMA guidelines and prospectively registered with PROSPERO, the authors searched PubMed, Web of Science, Embase, and the Cochrane Library databases. 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.

The key findings of the study were:

• Eight 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.

The authors concluded – “This systematic review and meta-analysis indicates that perioperative VC supplementation during THA/TKA may alleviate pain and attenuate inflammatory responses within 24 h postoperatively. Qualitative synthesis suggests it may reduce the risks of CRPS and bleeding, lower propofol requirements, decrease postoperative nausea incidence, and potentially confer cardioprotective and anti-fibrotic effects. However, given the limited number of relevant studies and insufficient data, large-scale, high-quality RCTs are warranted to validate these findings and establish robust evidence for clinical practice.”

MBBS, Dip. Ortho, DNB ortho, MNAMS

Dr Supreeth D R (MBBS, Dip. Ortho, DNB ortho, MNAMS) is a practicing orthopedician with interest in medical research and publishing articles. He completed MBBS from mysore medical college, dip ortho from Trivandrum medical college and sec. DNB from Manipal Hospital, Bengaluru. He has expirence of 7years in the field of orthopedics. He has presented scientific papers & posters in various state, national and international conferences. His interest in writing articles lead the way to join medical dialogues. He can be contacted at editorial@medicaldialogues.in.