Rotator cuff and Vitamin D - several studies

6+ Vitamin D Life pages have ROTATOR in the title

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Rotator Cuff tear severity associated with low Vitamin D – Feb 2024

Correlation Between Rotator Cuff Tear in Thai Urban Elderly Population and Vitamin D Deficiency
Cureus DOI: 10.7759/cureus.54986
Sutee Thaveepunsan 1, Ekkalak Kosasaeng 1, Yupadee Fusakul 2, Sitthiphong Suwannaphisit 3
1. Department of Orthopaedics, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, THA 2. Department of Rehabilitation, Vajira Hospital, Navamindradhiraj University, Bangkok, THA
3. Department of Orthopaedics/Hand and Microsurgery, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, THA

Background
The benefits of vitamin D encompass the augmentation of rotator cuff healing, the enhancement of bone mineral density (BMD), and the fortification of skeletal muscle strength. The vitamin D deficiency in Asian countries appears to be more severe compared to their Western counterparts. This study aims to ascertain the relationship between rotator cuff tears and vitamin D levels in the urban Thai elderly demographic. Our hypothesis posits that vitamin D deficiency will exhibit an association with the occurrence of rotator cuff tears.
Materials and methods
A prospective clinical trial conducted at a single tertiary was carried out to assess the patients experiencing shoulder pain who were aged 60 years or older. All participants were tested of blood specimens for calciferol concentration and magnetic resonance imaging (MRI). The duration between blood sample collection and magnetic resonance imaging (MRI) did not exceed a two-week window. The assessment of fatty degeneration in the supraspinatus, infraspinatus, and subscapularis muscles, as well as tear dimensions and cartilage thickness, was conducted using magnetic resonance imaging within the outpatient clinic.
Results
The analysis of serum vitamin D levels within a cohort comprising 59 subjects produced significant observations, indicating that 20.03% of the participants manifested a deficiency in vitamin D and 44.07% exhibited insufficiency in vitamin D levels. There was no observed correlation between serum vitamin D levels and various patient parameters, including age (P = .99), body mass index (P = 0.31), tear size (P = 0.41), cartilage thickness at different locations on the humeral head (superior, middle, inferior, and total) (P = 0.31, 0.40, 0.26, 0.20, respectively), degree of fatty infiltration of the rotator cuff (P = 0.81), and severity of the rotator cuff condition (P = 0.13). A significant positive correlation was established between rotator cuff tear size and both the severity of the rotator cuff condition (P < 0.001) and the degree of fatty infiltration of the cuff (P < 0.001).
Conclusion
A negative correlation is observed between serum vitamin D levels and various parameters, including tear size, fatty infiltration, cartilage thickness, and the severity of rotator cuff tears within the elderly urban Thai population. To affirm these findings, it is imperative to conduct additional research and integrate vitamin D assessments into the management strategies for aging populations with rotator cuff conditions.
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Cost of rotator cuff surgery reduced $46 if give a small amount of Vitamin D to all patients - Dec 2023

Preoperative vitamin D supplementation is a cost-effective intervention in arthroscopic rotator cuff repair
J. of Shoulder and Elbow Surgery Vol 32, Issue 12, Dec 2023, Pages 2473-2482 https://doi.org/10.1016/j.jse.2023.05.007 PDF behind paywall
Dhiraj Patel BA, Gregory Roy MD, Nathan Endres MD, Chason Ziino MD

Background
This study investigates the potential role of preoperative 25(OH)D supplementation as a cost-effective strategy to decrease revision rotator cuff repair (RCR) rates and lower the total health care burden from patients undergoing primary arthroscopic RCR. Previous literature has emphasized the importance of vitamin D on bone health maintenance, soft tissue healing, and outcomes in RCR. Inadequate preoperative vitamin D levels may increase revision RCR rates following primary arthroscopic RCR. Although 25(OH)D deficiency is common in RCR patients, serum screening is not routinely performed.

Methods
A cost-estimation model was developed to determine the cost-effectiveness of both preoperative selective and nonselective 25(OH)D supplementation in RCR patients in order to reduce revision RCR rates. Prevalence and surgical cost data were obtained from published literature through systematic reviews. Cost of serum 25(OH)D assay and supplementation were obtained from public-use data. Mean and lower and upper bounds of 1-year cost savings were calculated for both the selective and nonselective supplementation scenarios.

Results
Preoperative 25(OH)D screening and subsequent selective 25(OH)D supplementation was calculated to result in a mean cost savings of $6,099,341 (range: –$2,993,000 to $15,191,683) per 250,000 primary arthroscopic RCR cases. Nonselective 25(OH)D supplementation of all arthroscopic RCR patients was calculated to result in a mean cost savings of $11,584,742 (range: $2,492,401-$20,677,085) per 250,000 primary arthroscopic RCR cases. Univariate adjustment projects that selective supplementation is a cost-effective strategy in clinical contexts where the cost of revision RCR exceeds $14,824.69 and prevalence of 25(OH)D deficiency exceeds 6.67%. Additionally, nonselective supplementation is a cost-effective strategy in clinical scenarios where revision RCR cost is ≥$4216.06 and prevalence of 25(OH)D deficiency is ≥1.93%.

Conclusions
This cost-predictive model promotes the role of preoperative 25(OH)D supplementation as a cost-effective mechanism to reduce revision RCR rates and lower the overall health care burden from arthroscopic RCR. Nonselective supplementation appears to be more cost-effective than selective supplementation, likely due to the lower cost of 25(OH)D supplementation compared to serum assays.

Section snippets
Systematic review: prevalence of vitamin D deficiency in primary RCR and prevalence of revision RCR in vitamin D–deficient and vitamin D–sufficient patients
A systematic review of the literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to determine the prevalence of 25(OH)D deficiency in all primary arthroscopic RCR patients and the prevalence of revision RCR in both vitamin D–deficient and vitamin D–sufficient patients. The following key words were used for query: rotator cuff repair, vitamin D. After manual review of the 14 resulting studies, only 3 reported the prevalence of . . .

Results
Input data for our cost-predictive Markov model is outlined in Table I. Using this data, selective preoperative vitamin D screening and supplementation was calculated to result in a mean cost savings of $6,099,341 (range: –$2,993,000 to $15,191,683) per 250,000 primary arthroscopic RCR cases relative to the no supplementation scenario. Additionally, nonselective preoperative vitamin D supplementation of all patients was projected to result in a mean cost savings of $11,584,742 (range: . . .

Discussion
This analysis is the first cost-effectiveness study of a vitamin D supplementation–based intervention to reduce revision RCR rates and lower total US health care burden within the arthroscopic RCR population. Our model projects that both nonselective and selective 25(OH)D supplementation can be cost-effective preoperative interventions to reduce revision RCR rates and decrease total health care spending surrounding arthroscopic RCR. This finding builds on previous work associated with vitamin D . . .

Conclusion
Vitamin D plays a crucial role in calcium homeostasis, bone-to-tendon healing, and the maintenance of bone and muscle health. Previous literature suggests that inadequate vitamin D levels are associated with increased revision RCR rates following arthroscopic RCR. We developed a cost-predictive Markov model that supports the potential role of both selective and nonselective preoperative 25(OH)D supplementation as cost-effective strategies to decrease revision RCR rates and lower the total US . . .

References (68) online

Vitamin D Life – Trauma and surgery category contains:

Large dose Vitamin D before surgery was found to help by 35 studies
Vitamin D is needed before most surgeries – many studies and RCTs
4.8 X more likely to die within 28 days of ICU if low Vitamin D - Jan 2024
Sepsis is both prevented and treated by Vitamin D - many studies
Thyroidectomy and Vitamin D - many studies
Orthopaedic surgeries need Vitamin D – many studies
Cancer - After diagnosis   chemotherapy
TBI OR "Traumatic Brain Injury - 21 in title as of Sept 2022
Superbug (Clostridium difficile) Infections strongly associated with low vitamin D - many studies
Glutamine and Omega-3 have also been proven to help several traumas/surgeries
   Note: Vitamin D also prevents the need for various surgeries and Omega-3 prevents many concussions/TBI
Trauma and Surgery is associated with 22 other Vitamin D Life categories
  Such as loading dose 33, Mortality 23, Infant-Child 21 Intervention 19 Cardiovascular 13, Injection 13 in Sept 2022

Did you know?

• You can easily improve outcomes of many planned surgeries by increasing vitamin D ahead of time
  • Cancer surgery is the only known exception - extra Vitamin D is OK only if doctor reduces the chemo doses
• A loading dose of Vitamin D also improves unplanned hospital admissions
• Improvements include
  • Shorter recovery time
  • Shorter ICU time
  • Reduced deaths – in hospital, next month, next year
  • Reduced Sepsis = blood poisoning = infection