Orthopaedic surgeries need Vitamin D – many studies

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VitaminDWiki

• Vitamin D genes may be more important than (25(OH)D) to orthopedics – Review Dec 2022
• Reduced knee osteoarthritis if consistently supplement with vitamin D for 2 years – April 2017
• Total knee arthroplasty – worse outcome if low vitamin D – many studies
• 4 fewer days in hospital after hip or knee replacement if good level of vitamin D – June 2016
• Vitamin D and exercise after hip fracture surgery – far fewer deaths – July 2016
• Foot and Ankle Surgeries should benefit from Vitamin D – Feb 2019
• Noticed bones heal faster when more than 60 ng of vitamin D
• Vitamin D is needed before most surgeries – many studies and RCTs

Orthopedic Surgery can often be eliminated by increasing Vitamin D levels

• Vitamin D helps treat Osteoporosis – Sept 2018
• Knee osteoarthritis pain reduced by 60,000 IU monthly vitamin D following loading dose – RCT Nov 2013

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2 studies of Osteoporosis and Intervention

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4 studies of Osteoporosis and Surgery

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10 studies of Bone and Surgery

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VitaminDWiki - Osteoarthritis category contains 60 studies

60 items total - see also Overview Osteoporosis and vitamin D

Overview Osteoarthritis and Vitamin D
Knee Osteoarthritis treated by Vitamin D - meta-analysis Aug 2023
See also Ankylosing spondylitis
Rheumatic Diseases often treated by Vitamin D, may need 40-60 ng – Oct 2021
Knee osteoarthritis: Vitamin D is the 4th best treatment – meta-analysis Oct 2020

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VitaminDWiki pages with ORTHOPAEDIC in title (9 as of Dec 2022)

This list is automatically updated

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VitaminDWiki Surgery with HIP in title (11 as of Oct 2022)

This list is automatically updated

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Infections after bone surgery are associated with low vitamin D - Review Sept 2021

The role of Vitamin D in orthopaedic infection: a systematic literature review
Bone Jt Open . 2021 Sep;2(9):721-727. doi: 10.1302/2633-1462.29.BJO-2020-0192.R1.
Alexander Zargaran 1 2, David Zargaran 3, Alex J Trompeter 4

Aims: Orthopaedic infection is a potentially serious complication of elective and emergency trauma and orthopaedic procedures, with a high associated burden of morbidity and cost. Optimization of vitamin D levels has been postulated to be beneficial in the prevention of orthopaedic infection. This study explores the role of vitamin D in orthopaedic infection through a systematic review of available evidence.

Methods: A comprehensive search was conducted on databases including Medline and Embase, as well as grey literature such as Google Scholar and The World Health Organization Database. Pooled analysis with weighted means was undertaken.

Results: Pooled analysis of four studies including 651 patients found the mean 25(OH)D level to be 50.7 nmol/l with a mean incidence of infection of 70%. There was a paucity of literature exploring prophylactic 25(OH)D supplementation on reducing orthopaedic infection, however, there was evidence of association between low 25(OH)D levels and increased incidence of orthopaedic infection.

Conclusion: The results indicate a significant proportion of orthopaedic patients have low 25(OH]D levels, as well as an association between low 25(OH)D levels and orthopaedic infection, but more randomized controlled trials need to be conducted to establish the benefit of prophylactic supplementation and the optimum regimen by dose and time

Clipped from PDF
Haines et al 11 completed a randomized double-blind placebo-controlled trial of 113 adults with long-bone fractures, where patients in the intervention group were given a single dose of 100,000 IU of vitamin D orally within two weeks of their injury found that
infection occurred in

• 2% of the control group (n = 1/50) and
• none of the intervention group.

 Download the PDF from VitaminDWiki

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Current concepts in vitamin D and orthopaedic surgery - April 2019

Orthopaedics & Traumatology: Surgery & Research https://doi.org/10.1016/j.otsr.2018.12.006 1877-0568/
Andrews. Moona’b, Sellers Boudreaub, Eric Mussellb,Jun KitHeb’, Eugene W. Brabstonb, Brent A. Ponceb, Amit M. Momayab
a Tufts University School of Medicine, Boston, MA, USA
b Department of Orthopaedics, The University of Alabama at Birmingham, 951 18th St. S, 35205 Birmingham, AL, USA

 Download the PDF from VitaminDWiki

Introduction: Vitamin D plays an important role in the musculoskeletal system of the human body. Here, we review the most current literature on vitamin D as it relates to orthopaedic surgery and the musculoskeletal system, focusing largely on non-fracture applications.

Materials and methods: A literature review was performed on the basic science of vitamin D metabolism, epidemiology of vitamin D levels, role of vitamin D within the musculoskeletal system, and the correlation of vitamin D with injuries and orthopaedic surgical outcomes.

Results: The existing literature suggests vitamin D plays multiple roles in the musculoskeletal system. Recent research has shed light on the importance of vitamin D in the setting of soft tissue healing and recovery in addition to affecting postoperative outcomes after common orthopaedic procedures.
Conclusions: Given the widespread prevalence of vitamin D deficiency, orthopaedic surgeons should be aware of the current evidence regarding clinical implications in patients with musculoskeletal complaints.

Table 1: Vitamin D and orthopaedic procedures.

ACL reconstruction	Lowvitamin D levels (<30 ng/mL) may delay muscle strength recovery after ACL reconstruction [42] Decreased articular damage & inflammatory mediators in rats given intra-articular vitaminD injections post- in vivo ACL transections [9]
Rotator cuff	Low vitamin D levels may negatively affect early healing of rotator cuff repair sites in rats [43] Low vitamin D levels (<30 ng/mL) associated with fatty degeneration of rotator cuff[44] Vitamin D levels positively correlated with isokinetic muscle torque of the shoulder [44] Clinically, low vitamin D levels showed no correlation with outcomes (UCLA, CS, ASES) following rotator cuff repair [45]
Arthroplasty	Low vitamin D levels may result in longer hospital stays following TJA [65] High prevalence of low vitamin D levels in TJA patients [66] Low vitamin D levels (<20 ng/mL) associated with increased risk of postoperative complications, including periprosthetic joint infection [66,67]
Knee arthroplasty	Vitamin D deficient (<12ng/mL) patients undergoing TKA have significantly worse outcomes (KSS, alternative step-test, six-meter walk test) [57-60] Vitamin D deficient mice with intra-articular knee implants have increased bacterial burden and increased neutrophil infiltration in knee joint, reversible with vitamin D3 supplementation [68]
Hip arthroplasty	Lower pre- & postoperative Harris hip scores in vitamin D deficient THA patients [62] No association between vitamin D levels in THA patients & short-term postoperative outcomes (in-hospital milestones, length of stay, perioperative complications, WOMAC,SF-36, 2-minute walk test, & timed get up-and-gotests) [63,64]
Shoulder arthroplasty	High prevalence of low vitamin D levels in shoulder arthroplasty patients [29]

UCLA: University of California, Los Angeles; CS: Constant score; ASES: American Shoulderand ElbowSociety; KSS: American Knee SocietyScore; WOMAC: Western Ontario and McMasterUniversities Osteoarthritis Index; SF-36: Short-Form-36; TJA: totaljoint arthroplasty; TKA: total knee arthroplasty; THA: total hip arthroplasty.

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33,900 studies of Orthopedics and Vitamin D in Google Scholar as of Dec 2022

• The Role of Vitamin D in Pediatric Orthopedics, April 2019 - https://doi.org/10.1016/j.ocl.2018.10.002
• How can the orthopedic surgeon ensure optimal vitamin D status in patients operated for an osteoporotic fracture? May 2021 https://doi.org/10.1007/s00198-021-05957-9 FREE PDF
• Association of Pre-Operative Vitamin D Levels and Severity of Fracture among Orthopedic Trauma Patients in A Single, Tertiary-Level Hospital - Dec 2021 https://doi.org/10.1177/2210491721105694 FREE PDF
  • They appear to fail to suggest taking a loading dose of vitamin D BEFORE surgery
• Surgical Considerations for Vitamin D Deficiency in Foot and Ankle Surgery - April 2019 https://doi.org/10.1016/j.ocl.2018.10.008

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