Foot Ankle Int. 2018 Jan 1:1071100717745501. doi: 10.1177/1071100717745501. [Epub ahead of print]
Telleria JJM1, Ready LV1, Bluman EM1, Chiodo CP1, Smith JT1.
Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Vitamin D deficiency affects over 1 billion people worldwide and is common in foot and ankle patients. The prevalence in those with osteochondral lesions of the talus (OLTs) is unknown. This study identified the prevalence and risk factors for hypovitaminosis D in patients with an OLT.
Serum 25(OH)D levels were obtained from patients presenting with an OLT from May to November during 2007 to 2016. Hypovitaminosis D was defined as 25(OH)D less than 30 ng/mL (75 nmol/L). Patients presenting with an acute ankle sprain (AS) during the same months served as a control group. Specific medical risk factors for hypovitaminosis D were recorded. The final OLT population included 46 patients (31 women [67.4%]; mean [SD] age 43.6 [14.8] years). The comparison AS group had 40 patients (32 women [80.0%]; mean [SD] age 56.2 [13.0] years).
The mean (SD) 25(OH)D in the OLT and AS cohorts were 31.2 (12.6) ng/mL and 37.1 (13.5) ng/mL, respectively ( P = .039). Hypovitaminosis D was identified in 54% of the OLT population and 28% of the AS population ( P = .012).
Hypovitaminosis D is intimately related to decreased bone mineral density. This study identified a significantly higher rate of hypovitaminosis D in patients with an OLT compared to a cohort of AS patients. These findings suggest that when patients present with an OLT, health care providers should consider evaluating for and treating hypovitaminosis D.
LEVEL OF EVIDENCE: Level III, comparative study.
PMID: 29359597 DOI: 10.1177/1071100717745501
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- "Osteochondral lesions of the talus (OLT) occur in up to 70% of acute ankle sprains and fractures"
- "A systematic review by Zengerink et al4 demonstrated that up to 50% of patients failed to resolve their symptoms by conservative treatment. "
- "Unfortunately, there are no specific physical examination findings that can accurately assess and diagnose OLT, and up to 50% of patients have missed OLT on plain radiographs"
- Vitamin D is not mentioned once. The article highlights the need for surgery