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Total knee arthroplasty – worse outcome if low vitamin D – 2016, 17, 18, 2019

Better outcome if > 30 ng before TKA surgery Pakistan April 2019

Junaid Khan, Riaz Ahmed, Rahman Rasool Akhtar
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Objective: To determine the effect of pre-operative serum vitamin-D levels on the post-operative outcome in patients undergoing total knee arthroplasty.

Methodology: This prospective cohort study was conducted at the Department of Orthopaedics, Benazir Bhutto Hospital, Rawalpindi, Pakistan from 11th May 2017 to 10th May 2018. A total of 110 patients undergoing primary unilateral total knee arthroplasty (TKA) were enrolled in the study. Patients were placed into two groups. Group A included patients who had deficient vitamin-D3 levels (<30 ng/ml) while group B had patients with sufficient levels of vitamin-D3 (≥30 ng/ml). Functional evaluation was done pre-operatively and at 03 months post-operatively using American knee society score (KSS), Alternate step test (AST) and Six-meter walk test (SWT). Mean functional scores were compared using student’s t-test in SPSS version 23.

Results: There were 48 (43.64%) male and 62 (56.36%) female patients. Mean age of patients in group A was 60.87 ±5.10 years while in group B it was 60.09 ±4.78 years. Group A patients had mean vitamin-D levels of 13.56 ±6.12 ng/ml and those in group B had 41.49 ±9.95 ng/ml. At 3 months post-op, functional KSS showed a significant difference between the two groups (

  • 65.98 ±5.10 in group A and (<30 ng)
  • 74.87 ±5.02 in group B, p <0.01). (> 30ng)

The performance tests showed significant difference between the 02 groups (16.46 ±2.78 vs. 15.12 ±3.37, p =0.02 for AST) while (8.48 ±2.06 vs. 7.49 ±1.88, p =0.01, for SWT), respectively.

Conclusion: Pre-operative vitamin-D levels significantly affect the post-operative functional outcome in TKA.

Knee Arthroplasty complications were 2 X more likely if low vitamin D -May 2018

Better total knee arthroplasty outcomes if higher Vitamin D Levels - June 2016

Vitamin D deficiency adversely affects early post-operative functional outcomes after total knee arthroplasty
Knee Surgery, Sports Traumatology, Arthroscopy, pp 1–7, First Online: 17 June 2016
Keun-Young ShinKwan Kyu ParkSeong-Hwan MoonIck Hwan YangHo-June ChoiWoo-Suk Lee

Vitamin D has received considerable attention in recent years owing to the increasing evidence of its importance in muscle function and physical performance. The present study attempted to determine whether patients with low serum vitamin D levels had impairment in early functional outcomes following total knee arthroplasty (TKA).

This was a prospective cohort study that included 92 patients. Patients were divided into two groups according to their vitamin D levels as assessed at the preoperative visit: (1) vitamin D-deficient group, serum 25-hydroxyvitamin D3 (25(OH)D) levels <12 ng/mL; (2) vitamin D non-deficient group, serum 25(OH)D levels ≥12 ng/mL. American Knee Society Score (KSS) and four other performance tests including the alternative step test (AST), six-metre walk test (SMT), sit-to-stand test (STS), and timed up and go test (TUGT) were used for assessment of post-operative function. All assessments were performed one day before and three months after TKA.

Of the 92 patients included in the study, 87 patients performed all required assessments. The mean post-operative functional KSS was significantly lesser in the vitamin D-deficient group than in the vitamin D non-deficient group (67.2 vs. 73.4, p = 0.031). The mean values of time taken for post-operative AST (16.6 vs. 14.6 s, p = 0.033) and SMT (8.8 vs. 7.7 s, p = 0.012) were significantly longer in the vitamin D-deficient group than in the vitamin D non-deficient group. Post-operative STS and TUGT demonstrated higher values for mean time taken in the vitamin D-deficient group than in the vitamin D non-deficient group, but these were not statistically significant (13.6 vs. 12.4 s, not significant (n.s.); 12.7 vs. 11.7 s, n.s., respectively).

Early post-operative functional outcomes following TKA appear to be adversely affected by vitamin D deficiency.

Level of evidence: Prospective cohort study, Level II.

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Better Knee Osteoarthritis Outcomes if has higher vitamin D levels - May 2017

Maintaining Vitamin D Sufficiency Is Associated with Improved Structural and Symptomatic Outcomes in Knee Osteoarthritis
The American Journal of Medicine, online 24 May 2017, https://doi.org/10.1016/j.amjmed.2017.04.038

The aim of this study was to describe whether maintaining sufficient serum vitamin D levels in people with knee osteoarthritis and baseline vitamin D insufficiency has an association with change in knee structures and symptoms over 2 years.

Participants (n = 413, mean age 63.2 years) with symptomatic knee osteoarthritis and vitamin D insufficiency were enrolled in a clinical trial. In all, 340 participants (82.3%) completed the study, with 25-hydroxyvitamin D [25(OH)D] measurements at baseline and months 3 and 24. Participants were classified as consistently insufficient [serum 25(OH)D ≤50 nmol/L at months 3 and 24, n = 45], fluctuating [25(OH)D >50 nmol/L at either point, n = 68), and consistently sufficient [[25(OH)D >50 nmol/L at months 3 and 24, n = 226] groups. Knee cartilage volume, cartilage defects, bone marrow lesions, and effusion-synovitis volume were assessed using MRI at baseline and month 24. Knee symptoms were assessed at baseline and months 3, 6, 12, and 24 using the Western Ontario and McMaster Universities Arthritis Index.

The consistently sufficient group had significantly less loss of tibial cartilage volume (β 2.1%; 95% confidence interval [CI], 0.3%, 3.9%), less increase in effusion-synovitis volume (β −2.5 mL; 95 CI%, −4.7, −0.2 mL), and less loss of Western Ontario and McMaster Universities Arthritis Index physical function (β −94.2; 95% CI, −183.8, −4.5) compared with the consistently insufficient group in multivariable analyses. In contrast, there were no significant differences in these outcomes between the fluctuating and consistently insufficient groups. Changes in cartilage defects, bone marrow lesions, and knee pain were similar between groups.

This post hoc analysis suggests beneficial effects of maintaining vitamin D sufficiency on cartilage loss, effusion-synovitis, and physical function in people with knee osteoarthritis.

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Created by admin. Last Modification: Tuesday April 2, 2019 12:36:37 GMT-0000 by admin. (Version 13)

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