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4 fewer days in hospital after hip or knee replacement if good level of vitamin D – June 2016

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The items which are in both Intervention and Trauma/Surgery are listed here

Having enough vitamin D minimizes the need for hip/knee replacement

Hip and Knee 4 day - June 2016

Is there an association between low serum 25-OH-D levels and the length of hospital stay in orthopaedic patients after arthroplasty?
J Orthop Traumatol. 2016 Jun 13. [Epub ahead of print]
Maier GS1, Maus U2, Lazovic D2, Horas K3, Roth KE4, Kurth AA5.
1University Hospital of Orthopaedic Surgery, Pius-Hospital, Carl von Ossietzky University, Medizinischer Campus Universität, Georgstrasse 12, 26121, Oldenburg, Germany. gerrit.maier at uni-oldenburg.de.
2University Hospital of Orthopaedic Surgery, Pius-Hospital, Carl von Ossietzky University, Medizinischer Campus Universität, Georgstrasse 12, 26121, Oldenburg, Germany.
3ANZAC Research Institute, University of Sydney, Sydney, Australia.
4Department of Orthopaedic Surgery, Johannes Gutenberg University, Mainz, Germany.
5Department of Orthopaedic Surgery, Themistocles Gluck Hospital, Ratingen, Germany.
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BACKGROUND:
The purpose of this observational study was to evaluate serum levels of 25-OH-D in patients scheduled to undergo elective hip or knee arthroplasty. We hypothesised that 25-OH-D level is an independent risk factor for length of stay in orthopaedic patients after elective hip or knee arthoplasty.
MATERIALS AND METHODS:
25-OH-D levels were measured in 1083 patients admitted to an orthopaedic surgery department to undergo elective hip or knee arthroplasty. Comparisons were performed using Chi square or Student's t test, followed by univariate and multiple linear regression analysis examining the correlation between the length of stay in the orthopaedic department and 25-OH-D level while adjusting for possible confounders.
RESULTS:
Overall, 86 % of patients had insufficient serum levels of 25-OH-D, and over 60 % were vitamin D deficient. The mean length of stay was 13.2 ± 8.3 days. In patients with hypovitaminosis D, the length of stay was significantly longer compared to patients with normal serum 25-OH-D levels (15.6 ± 7.2 compared to 11.3 ± 7.9 days, P = 0.014). In univariate analyses, serum 25-OH-D level was inversely related to the length of stay in our orthopaedic department compared to patients with normal vitamin D levels (r = -0.16; P = 0.008). In multivariate analyses, the length of stay remained significantly associated with low 25-OH-D levels (P = 0.002), indicating that low vitamin D levels increase the length of stay.
CONCLUSIONS:
We found a high frequency of hypovitaminosis D among orthopaedic patients scheduled to undergo elective arthroplastic surgery. Low vitamin D levels showed a significant inverse association to the length of stay in our orthopaedic department. Patients with vitamin D levels in the target range were hospitalised 4.3 days less than patients with hypovitaminosis D. Level 3 of evidence according to "The Oxford 2011 levels of evidence".

PMID: 27294830


Knee or Hip Surgery – 1 day less in hospital if good level of vitamin D – meta-analysis July 2018

Vitamin D Status and Patient Outcomes after Knee or Hip Surgery: A Meta-Analysis
Ann Nutr Metab 2018;73:121–130, https://doi.org/10.1159/000490670
Zhang H.a · Zhu X.b · Dong W.c · Wang Q.-M.d

Background: This study evaluates the effect of vitamin D status in patient outcomes after hip or knee joint surgery.

Method: Literature search was carried out in electronic databases, and study selection followed predetermined eligibility criteria. Data were extracted from relevant studies and meta-analyses of standardized mean differences between hypovitaminosis D (vitamin D deficiency or insufficiency) and euvitaminosis D in assessment scores of patient-reported outcomes were performed.

Results: A total of 12 studies (2,593 patients; age 69.89 years [95% CI 68.07–71.70]; 35.95% [29.43–42.46] males) were included in the meta-analysis. The prevalence of hypovitaminosis D (vitamin D deficiency or insufficiency) was 33.18% [25.10–41.26], but the combined prevalence of deficiency and insufficiency was 46.99 [34.02–59.96].
Hospital stay was 1.09 days [–0.39 to 2.56] longer in the hypovitaminosis D group compared to the euvitaminosis D group.
Preoperatively, Harris Hip Score (HHS) and Knee Society Score were significantly lower (p = 0.001 and p = 0.00001, respectively) in the hypovitaminosis D group than in the euvitaminosis D group.
Postoperatively, HHS (p = 0.004) score was significantly lower in the hypovitaminosis D group than in the euvitaminosis D group.

Conclusion: The prevalence of hypovitaminosis D is high in osteoarthritis patients undergoing knee or hip surgery. Vitamin D deficiency may affect the outcomes of orthopedic joint surgery. However, randomized trial/s will be required to confirm these findings.

Attached files

ID Name Comment Uploaded Size Downloads
6783 arthroplasty.pdf PDF 2016 admin 14 Jun, 2016 14:21 370.41 Kb 157
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