Clinical Orthopaedics and Related Research®

, Volume 471, Issue 11, pp 3556–3562 | Cite as

Does Vitamin D Improve Osteoarthritis of the Knee: A Randomized Controlled Pilot Trial

  • Divya Sanghi
  • Abhishek Mishra
  • Amar Chandra Sharma
  • Ajai Singh
  • S. M. Natu
  • Sarita Agarwal
  • Rajeshwar Nath Srivastava
Clinical Research



Animal, epidemiologic, and human clinical studies suggest a putative role for vitamin D in osteoarthritis (OA). Inadequate sunlight exposure and lower serum levels of 25(OH)D appear in some reports to be associated with an increased risk for progression of knee OA.


We asked whether treatment with vitamin D would (1) reduce knee pain (WOMAC and VAS), (2) improve function (WOMAC), and (3) change levels of relevant biochemical markers in patients with knee OA with vitamin D insufficiency.


This randomized controlled pilot trial prospectively enrolled 107 patients with knee OA with vitamin D insufficiency (25(OH)D ≤ 50 nmol/L) to receive oral vitamin D or placebo. The primary outcome measures were pain and function, and the secondary were biochemical markers. At baseline, the two groups were comparable. The patients were followed for 1 year.


At 12 months, knee pain had decreased in the vitamin D group by mean −0.26 (95% CI, −2.82 to −1.43) on VAS and −0.55 (95% CI, −0.07 to 1.02) on the WOMAC, whereas in the placebo group, it increased by mean 0.13 (95% CI, −0.03 to 0.29) on the VAS and 1.16 (95% CI, 0.82 to 1.49) on the WOMAC (effect size = 0.37 and 0.78). Likewise knee function improved in the vitamin D group by mean −1.36 (95% CI, −1.87 to −0.85) over the placebo group which had a mean 0.69 (95% CI, −0.03 to 1.41; effect size = 0.06). There were significant biochemical changes in serum total calcium, 25(OH)D and alkaline phosphatase.


The results above suggest there is a small but statistically significant clinical benefit to vitamin D treatment in patients with knee OA, although we recommend a long-term study to determine whether these changes are clinically important and whether they will be sustained with time. Further studies with long-term radiologic evaluations are needed.

Level of Evidence

Level I, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.


Placebo Group Knee Pain Serum Phosphorus WOMAC Score WOMAC Pain 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We thank the Director, M.P.S. Negi MSc, Institute for Data Computing and Training, Lucknow, for providing valuable assistance in data analysis. We also thank Sachin Awasthi MS, PhD for assistance with making the OA diagnosis based on radiographs.


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Copyright information

© The Association of Bone and Joint Surgeons® 2013

Authors and Affiliations

  • Divya Sanghi
    • 1
  • Abhishek Mishra
    • 1
  • Amar Chandra Sharma
    • 1
  • Ajai Singh
    • 1
  • S. M. Natu
    • 2
  • Sarita Agarwal
    • 3
  • Rajeshwar Nath Srivastava
    • 1
  1. 1.Department of Orthopaedic SurgeryKing George’s Medical UniversityLucknowIndia
  2. 2.Department of PathologyKG Medical UniversityLucknowIndia
  3. 3.Department of Medical GeneticsSanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS)LucknowIndia

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