Are there any other supplements with evidence for healing after meniscus root repair surgery?

Supplements with Evidence for Healing After Meniscus Root Repair

Yes, vitamin D and calcium supplementation should be considered for patients undergoing meniscus root repair, particularly those with risk factors for deficiency, as these nutrients are essential for bone repair and healing. 1, 2, 3

Vitamin D and Calcium: The Primary Evidence-Based Supplements

Vitamin D (800-1,000 IU daily) and calcium (1,000-1,200 mg daily) are the only supplements with guideline-level support for bone and tissue healing in surgical contexts. 1, 2, 3

Rationale for Vitamin D and Calcium

• Vitamin D plays critical roles in skeletal health and bone repair, with receptors present on cells involved in bone metabolism 1, 3
• Patients undergoing orthopedic surgery frequently have risk factors for vitamin D deficiency including obesity, older age, and sedentary lifestyle—common characteristics in meniscus root tear patients 1, 3
• These supplements support immune function and wound healing with minimal side effects and relatively low cost 1
• The pragmatic recommendation exists despite limited direct evidence in meniscus repair, based on their fundamental importance in bone and tissue repair 1

Specific Dosing Recommendations

• Vitamin D: 600-800 IU daily (target serum level ≥20 ng/ml, though some experts recommend 40-50 ng/mL for optimal healing) 1, 2, 3
• Calcium: 1,000-1,200 mg daily (divided doses not exceeding 600 mg at once for optimal absorption) 1, 2
• Consider checking 25(OH)D levels preoperatively in patients with diabetes, obesity, or advanced age 3

Comprehensive Multivitamin for Non-Healing Cases

If healing is delayed or complications arise, a comprehensive multivitamin at 200% RDA taken twice daily should be prescribed, containing vitamins A, B-1, B-6, B-12, C, D, E, plus iron, copper, selenium, zinc, and magnesium. 2

Evidence for Multivitamin Supplementation

• In burn patients (a high-stress surgical model), this specific multivitamin regimen reduced wound infection from 77.4% to 30% (P < 0.001), sepsis from 41.9% to 13.3% (P = 0.021), and hospitalization from 76.81 to 51.80 days (P = 0.025) 2
• Vitamin C (500-1,000 mg daily) is required for collagen synthesis in all phases of wound healing 2
• Vitamin A (6,000-10,000 IU daily) is critical for epithelial formation and immune function 2
• Zinc (15-60 mg daily) is essential for wound healing and immune function 2
• B-complex vitamins at 200% RDA have demonstrated reduction in wound infection risk when combined with other micronutrients 2

Important Caveat

• Do not use nutritional supplementation as a substitute for proper surgical technique, adequate debridement, or standard wound care—supplements are adjunctive only 2
• Vitamin C supplementation may increase risk of acute kidney injury in certain populations, requiring renal function monitoring 2

Protein and Amino Acid Supplementation

Ensure adequate protein intake of 1.2-1.5 g/kg/day, as protein deficiency is the most important nutritional factor impeding wound healing. 2

• Consider arginine supplementation, which reduces infectious complications and hospital length of stay when given perioperatively 2
• Glutamine supplementation may decrease infections and hospital length of stay with minimal harm 2

Supplements with Limited Evidence in Knee Osteoarthritis Context

The following supplements have limited evidence for knee osteoarthritis but not specifically for meniscus root repair healing: 1

• Turmeric
• Ginger extract
• Glucosamine
• Chondroitin

These should not be prioritized over vitamin D and calcium for post-surgical healing, as the evidence is inconsistent and focused on chronic osteoarthritis pain rather than acute surgical healing 1

Collagen-Based Interventions

Atelocollagen application during surgery (not as an oral supplement) showed promise in one study, with lower intra-meniscal signal intensity suggesting better healing compared to conventional repair alone. 4

• This is an intraoperative adjunct rather than a postoperative supplement 4
• The study showed 72% complete healing with atelocollagen versus 54.5% without it 4
• However, this did not significantly reduce meniscal extrusion 4

Perioperative Supplement Management

Most supplements should be held 2 weeks before surgery due to potential interactions with anesthesia, bleeding risk, or metabolic effects. 1

• Supplements affecting blood glucose (alpha-lipoic acid, chromium, fenugreek, ginseng) should be held for 2 weeks preoperatively 1
• Supplements affecting coagulation should only be restarted once postoperative bleeding risk is minimal 1
• Cannabis products should be discontinued at least 3 days before elective surgery, ideally 2 weeks 1