Ascorbic Acid and Its Clinical Role in Orthopaedic Surgery


Ascorbic acid (vitamin C) is an essential micronutrient with evidence supporting its role in bone formation, tissue repair, and collagen production. Its clinical importance to the field of orthopaedic surgery has yet to be fully defined. Several observational studies have shown improved bone density and reduced hip fracture risk with supplementation. Its effect on bone fracture and soft tissue injury has been promising in animal models, but is not adequately studied in human trials. Results have been mixed concerning its role in chondroprotection and osteoarthritis treatment. Evidence suggesting reduced incidence of complex regional pain syndrome following distal radius fracture when treated with adjuvant ascorbic acid has prompted much debate but has received an endorsement of moderate support from the American Academy of Orthopaedic Surgeons. Given its potential benefits, low cost, and safety profile, ascorbic acid supplementation warrants consideration by orthopaedic surgeons in the treatment of a variety of musculoskeletal injuries (Journal of Surgical Orthopaedic Advances 27(4):261–268, 2018)
Key words: ascorbic acid, bone health, cartilage, complex regional pain syndrome, fracture healing, ligaments, osteoarthritis, osteoblast differentiation, tendons, vitamin C

Tianyi David Luo, MD; Anthony J. Marois, MD; Thomas L. Smith, PhD; Jeffrey S. Willey, PhD; and Cynthia L. Emory, MD