Current concepts in vitamin D and orthopaedic surgery
Orthopaedics & Traumatology: Surgery & Research https://doi.org/10.1016/j.otsr.2018.12.006 1877-0568/
Andrews. Moona’b, Sellers Boudreaub, Eric Mussellb,Jun KitHeb’, Eugene W. Brabstonb, Brent A. Ponceb, Amit M. Momayab
a Tufts University School of Medicine, Boston, MA, USA
b Department of Orthopaedics, The University of Alabama at Birmingham, 951 18th St. S, 35205 Birmingham, AL, USA
- Reduced knee osteoarthritis if consistently supplement with vitamin D for 2 years – April 2017
- Total knee arthroplasty – worse outcome if low vitamin D – 2016, 17, 18, 2019
- 4 fewer days in hospital after hip or knee replacement if good level of vitamin D – June 2016
- Vitamin D and exercise after hip fracture surgery – far fewer deaths – July 2016
- Foot and Ankle Surgeries should benefit from Vitamin D – Feb 2019
Orthopedic Surgery can often be eliminated by increasing Vitamin D levels
- Vitamin D helps treat Osteoporosis – Sept 2018
- Knee osteoarthritis pain reduced by 60,000 IU monthly vitamin D following loading dose – RCT Nov 2013
Items in both categories Osteoporsis and Intervention are listed here:
Items in both categories Osteoporsis and Surgery are listed here:
Osteoarthritis category includes the following
Overview Osteoarthritis and Vitamin D
Search Vitamin D Life for CARTILAGE 393 items as of July 2018
See also Ankylosing spondylitis
Search Vitamin D Life for "Knee Osteoarthritis" 410 items as of Oct 2020
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Introduction: Vitamin D plays an important role in the musculoskeletal system of the human body. Here, we review the most current literature on vitamin D as it relates to orthopaedic surgery and the musculoskeletal system, focusing largely on non-fracture applications.
Materials and methods: A literature review was performed on the basic science of vitamin D metabolism, epidemiology of vitamin D levels, role of vitamin D within the musculoskeletal system, and the correlation of vitamin D with injuries and orthopaedic surgical outcomes.
Results: The existing literature suggests vitamin D plays multiple roles in the musculoskeletal system. Recent research has shed light on the importance of vitamin D in the setting of soft tissue healing and recovery in addition to affecting postoperative outcomes after common orthopaedic procedures.
Conclusions: Given the widespread prevalence of vitamin D deficiency, orthopaedic surgeons should be aware of the current evidence regarding clinical implications in patients with musculoskeletal complaints.
Table 1: Vitamin D and orthopaedic procedures.
| ACL reconstruction | Lowvitamin D levels (<30 ng/mL) may delay muscle strength recovery after ACL reconstruction [42] Decreased articular damage & inflammatory mediators in rats given intra-articular vitaminD injections post- in vivo ACL transections [9] |
| Rotator cuff | Low vitamin D levels may negatively affect early healing of rotator cuff repair sites in rats [43] Low vitamin D levels (<30 ng/mL) associated with fatty degeneration of rotator cuff[44] Vitamin D levels positively correlated with isokinetic muscle torque of the shoulder [44] Clinically, low vitamin D levels showed no correlation with outcomes (UCLA, CS, ASES) following rotator cuff repair [45] |
| Arthroplasty | Low vitamin D levels may result in longer hospital stays following TJA [65] High prevalence of low vitamin D levels in TJA patients [66] Low vitamin D levels (<20 ng/mL) associated with increased risk of postoperative complications, including periprosthetic joint infection [66,67] |
| Knee arthroplasty | Vitamin D deficient (<12ng/mL) patients undergoing TKA have significantly worse outcomes (KSS, alternative step-test, six-meter walk test) [57-60] Vitamin D deficient mice with intra-articular knee implants have increased bacterial burden and increased neutrophil infiltration in knee joint, reversible with vitamin D3 supplementation [68] |
| Hip arthroplasty | Lower pre- & postoperative Harris hip scores in vitamin D deficient THA patients [62] No association between vitamin D levels in THA patients & short-term postoperative outcomes (in-hospital milestones, length of stay, perioperative complications, WOMAC,SF-36, 2-minute walk test, & timed get up-and-gotests) [63,64] |
| Shoulder arthroplasty | High prevalence of low vitamin D levels in shoulder arthroplasty patients [29] |
UCLA: University of California, Los Angeles; CS: Constant score; ASES: American Shoulderand ElbowSociety; KSS: American Knee SocietyScore; WOMAC: Western Ontario and McMasterUniversities Osteoarthritis Index; SF-36: Short-Form-36; TJA: totaljoint arthroplasty; TKA: total knee arthroplasty; THA: total hip arthroplasty.
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