Effects of preoperative serum vitamin D levels on early clinical function outcomes and the moderate-to-severe pain prevalence in postmenopausal women after primary total knee arthroplasty

Abstract

Objective:To investigate the impact of vitamin D levels on early clinical function outcomes and the potential risk factors of moderate-to-severe pain prevalence in postmenopausal women after primary total knee arthroplasty (TKA).Methods:From April 2017 to December 2019, 226 women were retrospectively recruited. The women were divided into two groups based on their preoperative serum 25-hydroxyvitamin D levels: (1) vitamin D-sufficient group (≥30 ng/mL); (2) vitamin D-deficient group (<30 ng/mL). The visual analog scale, Western Ontario and McMaster Arthritis Index score, and Knee Society Score were used to evaluate clinical outcomes. Risk factors for developing postoperative moderate-to-severe knee pain were studied using multivariate binary logistic regression analyses.Results:There was no significant difference in preoperative clinical function assessment between the two groups. The difference in postoperative Western Ontario and McMaster Arthritis Index score between the two groups was statistically significant (15.3 ± 0.7 vs 15.6 ± 0.7: P = 0.02). However, the differences in postoperative visual analog scale and Knee Society Score scores between the two groups were not significant (P > 0.05). The incidence of postoperative moderate-to-severe pain was 16.4% (95% CI 11.8%-21.9%). Multivariate logistic regression analysis revealed that vitamin D deficiency, smoking, and high body mass index were potential risk factors for moderate-to-severe knee pain in postmenopausal women early after TKA (P < 0.05).Conclusion:Preoperative vitamin D deficiency may adversely affect early functional outcomes in postmenopausal women after TKA. In addition, vitamin D deficiency, smoking, and high body mass index were independent risk factors for moderate-to-severe knee pain after surgery.

Vitamin D Metabolic Pathway Components in Orthopedic Patientes—Systematic Review

“…It has been proven that implant survival was significantly better in people taking a combination of calcium and vitamin D (at a dose of 800 IU or more) for more than 1 year compared to those who had never used it ( p < 0.001) [ 20 ]. Song et al (2021) [ 21 ] undertook to investigate the effect of vitamin D levels on early clinical function outcomes and potential risk factors for moderate to severe pain in postmenopausal women after TKA. The study included 226 women who were included in the group: the group with normal serum vitamin D concentration (level ≥ 30 ng/mL) and the group with vitamin D deficiency (level < 30 ng/mL).…”

“…The study included 226 women who were included in the group: the group with normal serum vitamin D concentration (level ≥ 30 ng/mL) and the group with vitamin D deficiency (level < 30 ng/mL). Although there was no significant difference in preoperative assessment of clinical function between the two groups, the authors concluded that vitamin D deficiency may adversely affect early functional outcomes in postmenopausal women after TKA and may be considered as a risk factor for moderate to severe postoperative knee pain (in correlation with smoking and high mass index) [ 21 ].…”

Preoperative Vitamin D Level is Associated with Acute Pain After Video-Assisted Thoracoscopic Surgery: A Retrospective Cohort Study

“…They reported that vitamin D deficiency was a risk factor for postoperative pain at 3 months after surgery. 8 However, in an observational study, Bose et al did not observe a link between vitamin D levels and postoperative pain after laparoscopic bariatric surgery. 20 This discrepancy may be attributed to differences in patient populations, particularly in terms of vitamin D levels and the types of surgery performed.…”

“…3,6,7 Several studies have reported that vitamin D deficiency is associated with musculoskeletal pain, cancer pain, postoperative pain, and post-traumatic pain. [8][9][10][11][12][13][14][15] Low vitamin D levels have been linked with higher opioid use and an increased risk of opioid use disorders in patients undergoing common surgical procedures. 10,16 Two meta-analyses of randomized controlled trials (RCTs) highlighted a correlation between vitamin D supplementation and pain reduction.…”

The Role of Genetic Polymorphisms in Diabetic Retinopathy: Narrative Review

“…It could also inhibit diabetes-induced retinal leukostasis and leakage. Taking all of this together, one action of PPAR-γ is considered capable of reducing the progression of DR [51,52]. Finding that one of the missense mutations (rs1801282 C/G, known as Pro12Ala, and quite common in some populations) could influence the risk of insulin resistance and influences lipid metabolism [53] focused the attention of researchers working with DR risk factors.…”