High prevalence of vitamin D deficiency in elderly patients with advanced osteoarthritis scheduled for total knee replacement associated with poorer preoperative functional state

Ja, Jansen; Fs, Haddad

doi:10.1308/rcsann.2013.95.8.569

Cited by 53 publications

(30 citation statements)

References 18 publications

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“…Five studies were of high methodological quality, 11 , 14 , 15 , 18 , 21 12 were of moderate quality 12 , 13 , 16 , 17 , 19 , 20 , 22 - 25 , 27 , 28 and 1 of low quality. 26 …”

Section: Resultsmentioning

confidence: 99%

<p>The Effect of Perioperative Vitamin D Levels on the Functional, Patient-Related Outcome Measures and the Risk of Infection Following Hip and Knee Arthroplasty: A Systematic Review</p>

Kenanidis

Kakoulidis

Karponis

et al. 2020

PROM

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Introduction The aim of this study was to evaluate the effect of perioperative vitamin D levels in terms of functional results, patient-related outcome measures (PROMs) and infection risk after hip or knee replacement. Materials and Methods A systematic search in PubMed, Cochrane library, ScienceDirect and ClinicalTrials.gov was conducted according to the PRISMA guidelines from inception to January 2020. Results Eighteen studies with more than 8000 knee and 1500 hip joint arthroplasties were included. The mean follow-up ranged from 6 weeks to 1 year and mean patients’ age from 59.4 to 76 years. Hypovitaminosis was diagnosed in 26.7% of cases. Most studies did not find significant differences in pre- and postoperative functional results, PROMs and length of hospital stay between hypovitaminosis and euvitaminosis groups. Deficient patients may be at higher risk of postoperative joint stiffness. Patients suffering from hip and knee periprosthetic joint infection seem to have lower vitamin D levels compared to those with aseptic loosening of implants. Conclusion The necessity of pre-operative correction of vitamin D levels to achieve better functional results and minimize the risk of infection following hip and knee arthroplasty remains inconclusive. Extend of exposure to low vitamin D levels and comparison between outliers needs further evaluation.

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“…Five studies were of high methodological quality, 11 , 14 , 15 , 18 , 21 12 were of moderate quality 12 , 13 , 16 , 17 , 19 , 20 , 22 - 25 , 27 , 28 and 1 of low quality. 26 …”

Section: Resultsmentioning

confidence: 99%

<p>The Effect of Perioperative Vitamin D Levels on the Functional, Patient-Related Outcome Measures and the Risk of Infection Following Hip and Knee Arthroplasty: A Systematic Review</p>

Kenanidis

Kakoulidis

Karponis

et al. 2020

PROM

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“…[ 14 ] knee arthroplasty prospective, observational 75 33 no 25(OH)D, LC-MS/MS continuous 3 months vitamin D status declines for 3 months after surgery, is not correlated with changes in C-reactive protein concentrations Jansen et al . [ 15 ] knee arthroplasty prospective, observational 71 139 no 25(OH)D, RIA categorical, 16 ng/mL threshold 6 months decreased Knee Society scores, “lack of power” Barker et al . [ 16 ] anterior cruciate ligament repair retrospective 31 18 no 25(OH)D, CIA categorical, 30 ng/mL threshold 3 months decreased postoperative knee strength Lee et al .…”

Section: Resultsmentioning

confidence: 99%

“…Five publications observed no significant difference in the incidence of adverse outcomes between groups with lower and higher vitamin D status [ 11 , 14 , 15 , 17 , 34 ]. However, in none is it clear that no difference truly exists, or if design and conduct constraints preclude detection of a correlation.…”

Section: Resultsmentioning

confidence: 99%

“…concede “missing data could be responsible for lack of power to show any significance at all”. [ 15 ]. Similarly, Unnanuntana conclude “Considering that our definition of vitamin D deficiency was determined at higher serum levels than previously reported, this could potentially explain the apparent lack of association between vitamin D status and the attainment of functional milestones”.…”

Section: Resultsmentioning

confidence: 99%

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Vitamin D status and surgical outcomes: a systematic review

Iglar

Hogan

2015

Patient Saf Surg

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The importance of vitamin D for musculoskeletal health has long been recognized, and awareness of significant extra-skeletal effects in health and disease is rapidly emerging. Although it has been possible for many decades to quantify serum markers of vitamin D deficiency, and to correct deficiency at low cost and with high safety, the influence of vitamin D status on post-surgical outcomes has only recently been identified as a research topic of interest. To the present, these data have not been the subject matter of formal review. Accordingly, we conducted a systematic review to assess the association between perioperative vitamin D status and outcomes after surgery. The databases of PubMed, Ovid MEDLINE, EMBASE, AMED, CINAHL (EBSCOHost), The Cochrane Databases of Systematic Review, and PROSPERO were searched through December, 2014 for studies relating to vitamin D and surgery. The initial search yielded 90 manuscripts. After applying exclusion criteria, 31 studies were eligible for inclusion. Fifteen studies employed prospective observational designs, 3 used prospective randomized protocols, and 13 report retrospective database interrogations. The main finding of the present review is that 26 of 31 studies (84%) report at least one statistically significant worse outcome in patients with low vitamin D status. Five of 31 studies (16%) found no association. In conclusion, this review supports the hypothesis that hypovitaminosis D is associated with adverse outcomes after diverse surgical procedures. Future studies should focus on additional surgeries and outcomes, and on the role of vitamin D supplementation in the improvement of patient safety in participants with low vitamin D status at the time of surgery.

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“…Because TKA results in substantial injury to extensor mechanism of the knee, it is pertinent to evaluate the association between serum vitamin D levels and functional recovery following TKA. In a recent study correlating vitamin D levels with postoperative outcomes in patients undergoing TKA, patients with vitamin D deficiency (defined as serum 25(OH) D < 16 ng/mL) had lower preoperative KSS (31.5 vs. 37.1, p = 0.047) when compared to patients without deficiency [24]. Although the post-operative KSS was also lower in patients with vitamin D deficiency, the difference between the two groups was not statistically significant (74.6 vs. 80.4, n.s.).…”

Section: Discussionmentioning

confidence: 99%

Vitamin D deficiency adversely affects early post-operative functional outcomes after total knee arthroplasty

Shin

Park

Moon

et al. 2016

Knee Surg Sports Traumatol Arthrosc

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High prevalence of vitamin D deficiency in elderly patients with advanced osteoarthritis scheduled for total knee replacement associated with poorer preoperative functional state

Cited by 53 publications

References 18 publications

<p>The Effect of Perioperative Vitamin D Levels on the Functional, Patient-Related Outcome Measures and the Risk of Infection Following Hip and Knee Arthroplasty: A Systematic Review</p>

<p>The Effect of Perioperative Vitamin D Levels on the Functional, Patient-Related Outcome Measures and the Risk of Infection Following Hip and Knee Arthroplasty: A Systematic Review</p>

Vitamin D status and surgical outcomes: a systematic review

Vitamin D deficiency adversely affects early post-operative functional outcomes after total knee arthroplasty

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