Effect of Preoperative Vitamin D Levels on Functional Performance after Total Knee Arthroplasty

Abstract

BackgroundLow vitamin D levels affects muscle function. Vitamin D and calcium deficiency cause osteomalacic myopathy and poor functional recovery after hip fractures. The relationship of vitamin D and functional performance after total knee arthroplasty (TKA) is not previously reported.MethodsInfluence of vitamin D on functional performance before and after TKA was reviewed retrospectively in 120 patients. Of these, 64 had vitamin D deficiency (25-hydroxy vitamin D < 30 ng/mL) preoperatively. All 120 patients received vitamin D oral supplementation postoperatively. Functional parameters including Western Ontario and McMaster Osteoarthritis Index (WOMAC), Short-Form Health Survey questionnaire, and Knee Society Score were assessed pre- and postoperatively at 3 months.ResultsPreoperative function was significantly lower in osteoarthritic patients with vitamin D deficiency (WOMAC score; p = 0.040), but at 3 months all functional scores were similar.ConclusionsWe concluded that vitamin D deficiency has a negative effect on function in knee osteoarthritic patients. However, postoperative vitamin D supplementation can lead to functional recovery in these patients. Thus, TKA should not be delayed in vitamin D deficient patients; rather supplementation in the postoperative period is preferable to achieve comparable functional outcome at 3 months to patients with vitamin D sufficiency.

Factors That Affect Outcome Following Total Joint Arthroplasty: a Review of the Recent Literature

“…Some of the variables that have been shown to affect the outcome after total joint replacement include social and demographic characteristics, medical comorbidities, and surgical technique [3][4][5][6][7]. Areas of continued active research include the effect of intrinsic factors such as obesity [8][9][10], cardiovascular disease [11,12], mental health disorders [13•, 14-17•, 18•, 19], hepatic disease [20, 21•, 22, 23•, 24], nutritional deficiencies [25-29•, 30], bone metabolic disease [31][32][33][34][35][36][37], and diabetes mellitus [38•, 39, 40], as well as external factors such as nicotine use [41,42], recent corticosteroid injections [43][44][45][46][47], and discharge disposition [48,49]. The goal of this article is to review the most recent literature, published within the last 3 years, regarding a selection of patient-specific factors that may influence This article is part of the Topical Collection on Quality and Cost Control in TJA outcomes following total joint arthroplasty.…”

The effectiveness of vitamin D supplementation in functional outcome and quality of life (QoL) of lumbar spinal stenosis (LSS) requiring surgery

“…Second, there are many studies on LSS associated with various chronic diseases such as diabetes, hypertension, chronic obstructive pulmonary disease, and gout, but there has been no study on mutual causal relationship [24]. In addition, several authors have shown that vitamin D itself has the effect of preventing the deterioration of the physical function of a patient by preventing the chronic disease such as cancer, osteoarthritis, diabetes, and cardiovascular diseases [4,7,25,26]. This study showed a drawback that errors due to factors related to chronic diseases of patients who needed surgery could not be completely eliminated.…”

Vitamin D Status and Patient Outcomes after Knee or Hip Surgery: A Meta-Analysis

“…Twelve studies were included in the meta-analysis [27][28][29][30][31][32][33][34][35][36][37][38]. A flowchart of study screening and selection process is presented in Figure 1.…”