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Orthopaedic surgery Vitamin D – April 2019

Current concepts in vitamin D and orthopaedic surgery

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


Orthopedic Surgery can often be eliminated by increasing Vitamin D levels

Items in both categories Osteoporsis and Intervention are listed here:

Items in both categories Osteoporsis and Surgery are listed here:

Osteoarthritis category includes the following

51 items total - see also Overview Osteoporosis and vitamin D

Overview Osteoarthritis and Vitamin D
Search VitaminDWiki for CARTILAGE 393 items as of July 2018
See also Ankylosing spondylitis
Search VitaminDWiki for "Knee Osteoarthritis" 410 items as of Oct 2020

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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.

Created by admin. Last Modification: Sunday April 14, 2019 19:13:05 GMT-0000 by admin. (Version 7)

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