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Before joint replacement surgery low Vitamin D associated with systemic disease – Aug 2018

High prevalence and seasonal variation of hypovitaminosis D in patients scheduled for lower extremity total joint arthroplasty.

Ann Transl Med. 2018 Aug;6(16):321. doi: 10.21037/atm.2018.08.21.
Piuzzi NS1,2, George J1, Khlopas A1, Klika AK1, Mont MA1,3, Muschler GF1, Higuera CA4.
1 Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, OH, USA.
2 Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
3 Department of Orthopaedic Surgery, Lenox Hill Hospital, New York, NY, USA.
4 Department of Orthopaedic Surgery, Cleveland Clinic, Weston, FL, USA.


American Society of Anesthesiologists' ASA Score ≥3 was a risk factor for vitamin D <30 ng/mL
Before hip or knee replacement surgery Cleveland Ohio(?) 2006-2016

ASA score (from the web))

Trauma and surgery category starts with the following

Trauma and Surgery category has 326 articles

see also Concussions
Overview Fractures and Falls and Vitamin D
Cancer - After diagnosis   chemotherapy
TBI OR "Traumatic Brain Injury - 21 in title as of Sept 2022
Large dose Vitamin D before surgery was found to help by 35 studies
Vitamin D is needed before most surgeries – many studies and RCTs
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 VitaminDWiki categories
  Such as loading dose 33, Mortality 23, Infant-Child 21 Intervention 19 Cardiovascular 13, Injection 13 in Sept 2022

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High rates of vitamin D insufficiency and deficiency have been demonstrated in various patient populations, including patients undergoing total joint arthroplasties (TJA). However, the risk factors associated with this condition and its seasonal variation is still to be determined in patients scheduled for elective TJA.

We retrospectively identified 226 (116 hips, 120 knees) patients who underwent primary TJA, and had a vitamin D measurement, at a single institution (latitude, 41° 30' N) from 2006 to 2016. Demographics, comorbidities, and perioperative data were collected from electronic medical records. Patients were stratified into vitamin D sufficient (≥30 ng/mL), insufficient (<30 ng/mL), and deficient group (<20 ng/mL). Multivariate regression analyses were used to study the risk factors for vitamin D insufficiency and deficiency.

There were 99/226 (43.8%) patients in the vitamin D sufficient group, 137/226 patients (60.6%) in the insufficient group, of which 61/226 (26.9%) were in the deficient group. On multivariate analysis, an American Society of Anesthesiologists' (ASA) score ≥3 was a risk factor for vitamin D insufficiency (P<0.001), while ASA ≥3 (P<0.001) and younger age (P=0.002) were risk factors for vitamin D deficiency. Vitamin D levels varied between the quarters with lowest level seen in quarter 1 (P=0.015).

There was an overall high prevalence of vitamin D insufficiency (60%) and deficiency (27%). Due to higher risk of hypovitaminosis D, particular attention should be placed in patients with an ASA score ≥3, and patients scheduled during winter season.

Conclusion from PDF
Patients scheduled for lower extremity TJA in a region of the United States, whose latitude is 41° 30' N, have an overall high prevalence of vitamin D insufficiency (60%) and deficiency (27%). Based on our findings, due to higher risk of hypovitaminosis D, particular attention should be placed in patients with an ASA score ≥3, and scheduled during winter season. Further research is needed to establish the definitive prevalence of hypovitaminosis D and the potential detrimental effect it could have on patient outcomes following TJA. Furthermore, cost-benefit analysis must determine if universal screening or treatment should be included in TJA preoperative guidelines. In summary, although we were able to identify several risk factors associated with low vitamin D insufficiency and deficiency, the effect of these conditions on patient outcomes following TJA remains to be determined, as there is a paucity of studies demonstrating causal relationship between low vitamin D levels and poor patient outcomes.

Created by admin. Last Modification: Wednesday October 19, 2022 12:44:48 GMT-0000 by admin. (Version 8)

Attached files

ID Name Comment Uploaded Size Downloads
10744 ASA Score.jpg admin 27 Oct, 2018 13:38 18.27 Kb 501
10741 TJA F1.jpg admin 27 Oct, 2018 12:32 12.51 Kb 439
10740 TJA T1.jpg admin 27 Oct, 2018 12:31 32.35 Kb 729
10739 TJA ASA.pdf p admin 27 Oct, 2018 12:30 259.79 Kb 655