A critical review of brand and generic alendronate for the treatment of osteoporosis.

BACKGROUND

There is an emerging role for vitamin E in orthopaedics due to its antioxidant, immunomodulation and anti-inflammatory effects. The current review aims to comprehensively evaluate evidence regarding the use, benefits, pitfalls and future implications of vitamin E in diverse subspecialties of orthopaedics.

MATERIALS AND METHODOLOGY: A comprehensive search of literature was performed on 5 databases on January 5, 2025. The manuscripts, which pertain to examining the role of vitamin E in orthopaedics, were considered. Among them, opinions, editorials, letters, case reports and non-English manuscripts were excluded.

RESULTS

19 manuscripts were selected for our review. Vitamin E is utilised in diverse forms in orthopaedic patients: administered systemically, intraarticularly or locally. Systemically-administered vitamin E can mitigate osteoarthritis progression through strengthening of adjoining musculature, gene regulation, protection of subchondral vasculature, and anti-inflammatory properties. Vitamin E incorporation has been demonstrated to improve the wear characteristics of highly crosslinked polyethylene and metal alloys in arthroplasty through its antioxidant and osteointegrative abilities. Antioxidant vitamin E has been shown to mitigate postoperative arthrofibrosis and septic loosening. Vitamin E can positively influence late callus formation during secondary fracture healing. Through its effects on osteoblastic cells, proinflammatory cytokines, growth factors, antioxidant mechanism, hormones and micro-RNA, systemic vitamin E administration can meliorate osteoporosis and mitigate fractures.

CONCLUSION

There is emerging evidence regarding the roles of vitamin E in diverse orthopaedic conditions like osteoarthritis, osteoporosis, fracture healing, osteomyelitis and arthroplasty. These actions are attributed to its antioxidant, anti-inflammatory, and immunomodulatory functions. Large-scale trials are needed to ascertain its safety and future prospects.