Surgery complications cut in half by 300,000 IU of vitamin D 2 weeks before (hip and knee) – RCT
Effect of Vitamin D Deficiency on Periprosthetic Joint Infection and Complications After Primary Total Joint Arthroplasty
J Arthroplasty 2024 May 10:S0883-5403(24)00445-5. doi: 10.1016/j.arth.2024.05.012
Murat Birinci 1, Ömer S Hakyemez 1, Muhammed A Geçkalan 2, Müren Mutlu 3, Fatih Yildiz 2, Ömer F Bilgen 3, İbrahim Azboy 1
Background: Vitamin D deficiency is a global problem, and 13 to 75% of patients undergoing total joint arthroplasty (TJA) have vitamin D deficiency. Several studies have shown that low preoperative vitamin D levels may increase the risk of postoperative complications, including periprosthetic joint infection (PJI), in patients undergoing primary TJA. Most of the studies are underpowered. This study aimed to investigate the relationship between vitamin D deficiency and surgical and medical complications after primary TJA, with a specific focus on PJI.
Methods: Prospectively collected institutional multicenter arthroplasty databases were reviewed to identify patients who underwent primary total knee and hip arthroplasty. The study group was defined as patients whose vitamin D level is < 30 ng/dL and who received a single oral dose of 7.5 mg (300,000 IU) D3 within two weeks before index surgery (n = 488; mean age 63 years). Patients in the control group were those whose preoperative vitamin D levels were unknown and who did not receive vitamin D supplementation (n = 592, mean age 66). The groups were compared regarding 90-day medical and surgical complications, including PJI, mortality, and readmission rates.
Results: The total number of complications (8.6 and 4.3%; respectively; P = .005), superficial wound infection (2.5 and 0.2%, respectively; P < .001), and postoperative cellulitis (2.2 and 0% respectively; P < .001) were statistically significantly higher in the patient group who did not receive vitamin D supplementation. However, 90-day mortality (P = .524), PJI (P = .23), and readmission rate (P = .683) were similar between the groups.
Conclusions: This study demonstrated that preoperative optimization of vitamin D levels may be beneficial in reducing postoperative complications, including superficial wound infection and postoperative cellulitis. Administering an oral 300,000 U single-dose vitamin D regimen to correct vitamin D deficiency can positively impact outcomes following primary TJA.
📄 Download the PDF from VitaminDWiki
VitaminDWiki – Loading Dose of Vitamin D category contains
{include}
VitaminDWiki - studies in both categories Surgery and Loading Dose
This list is automatically updated
{category}
Many other studies have found benefits from giving Vitamin D before surgery
Large dose Vitamin D before surgery was found to help by 35 studies
Vitamin D is needed before many surgeries – many studies and RCTs
Restore your Vitamin D levels before surgery (Gastric Cancer in this case) - Jan 2023
Vitamin D before surgery improves outcome (spinal in this case) – Dec 2022
Rotator Cuff repair using Vitamin D lowers medical cost by 46 dollars – June 2023
Half as much AFIB after bypass if 600,000 IU of vitamin D before surgery – RCT April 2022
Pre-operative Vitamin D often helps (thyroidectomy in this case) – June 2021
Loading dose lasts < 2 months, more benefits if take 50,000 IU weekly starting 2 weeks after surgery
Continue with 50K weekly until healed, then can drop back to 50K once every 2 weeks
