HIGH PREVALENCE OF VITAMIN D DEFICIENCY IN PATIENTS UNDERGOING TOTAL KNEE ARTHROPLASTY
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Abstract
Introduction: Vitamin D deficiency is a widespread global health issue that affects a significant portion of the population, particularly in individuals with conditions that compromise bone health and musculoskeletal function.Objective: The main objective of the study is to find the high prevalence of vitamin D deficiency in patients undergoing total knee arthroplasty.Methodology: This prospective cohort study was conducted at Niazi Medical and Dental College, Sargodha during august 2023 to august 2024. Data were collected from 178 patients. Patients aged 40 years and older, with a confirmed diagnosis of knee osteoarthritis and a recommendation for TKA based on clinical assessment and imaging studies were included in the study.Results: Data were collected from 178 patients. Of the 178 patients, 40.4% (72 patients) were deficient in vitamin D (<20 ng/mL), while 46.1% (82 patients) had insufficient levels (20-30 ng/mL). Only 13.5% (24 patients) had sufficient vitamin D levels (>30 ng/mL). These findings highlight the high prevalence of vitamin D deficiency and insufficiency in this surgical population, indicating the potential need for supplementation in preoperative care.In terms of postoperative surgical site infections (SSIs), the infection rate was higher in the vitamin D-deficient group (6.9%, n=5 out of 72) compared to the vitamin D-sufficient group (4.2%, n=1 out of 24).Conclusion: It is concluded that vitamin D deficiency is highly prevalent in patients undergoing total knee arthroplasty and is associated with increased postoperative complications, including surgical site infections and delayed functional recovery.
References
2. Dhaliwal R, Aloia JF. Effect of Vitamin D on Falls and Physical Performance. Endocrinol Metab Clin North Am. 2017;46:919–933. doi: 10.1016/j.ecl.2017.07.004.
3. Shin KY, Park KK, Moon SH, Yang IH, Choi HJ, Lee WS. Vitamin D deficiency adversely affects early post-operative functional outcomes after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2017;25:3424–3430. doi: 10.1007/s00167-016-4209-8.
4. Piuzzi NS, George J, Khlopas A, Klika AK, Mont MA, Muschler GF, Higuera CA. High prevalence and seasonal variation of hypovitaminosis D in patients scheduled for lower extremity total joint arthroplasty. Ann Transl Med. 2018;6:321. doi: 10.21037/atm.2018.08.21.
5. Arima K, Mizukami S, Nishimura T, Tomita Y, Nakashima H, Abe Y, Aoyagi K. Epidemiology of the association between serum 25-hydroxyvitamin D levels and musculoskeletal conditions among elderly individuals: a literature review. J Physiol Anthropol. 2020;39:38. doi: 10.1186/s40101-020-00249-3.
6. Linde KN, Puhakka KB, Langdahl BL, Søballe K, Krog-Mikkelsen I, Madsen F, Stilling M. Bone Mineral Density is Lower in Patients with Severe Knee Osteoarthritis and Attrition. Calcif Tissue Int. 2017;101:593–601. doi: 10.1007/s00223-017-0315-y.
7. 23.Kim SH, Oh JE, Song DW, Cho CY, Hong SH, Cho YJ, Yoo BW, Shin KS, Joe H, Shin HS, Son DY. The factors associated with Vitamin D deficiency in community dwelling elderly in Korea. Nutr Res Pract. 2018;12:387–395. doi: 10.4162/nrp.2018.12.5.387.
8. Ganie MA, Sahar T, Wani I, Rashid A, Robbani I, Nisar S, Charoo BA, Bhat MA, Gania M, Farooq Q, Vishnubhatla S, Lakshmy R, Parvez T. Vitamin D status among Kashmiri tribal population: A cross-sectional community-based study. Indian J Med Res. 2022 Aug;156(2):348-356. doi: 10.4103/ijmr.IJMR_544_19. PMID: 36629195; PMCID: PMC10057367.
9. Meena N, Singh Chawla SP, Garg R, Batta A, Kaur S. Assessment of vitamin D in rheumatoid arthritis and its correlation with disease activity. J Nat Sci Biol Med. 2018;9:54–8.
10. Sintzel MB, Rametta M, Reder AT. Vitamin D and multiple sclerosis:A comprehensive review. Neurol Ther. 2018;7:59–85.
11. Dar MA, Raina AA, Masoodi SR, Mir MM. Assessment of vitamin d status in pregnant women, a prospective observational study from Kashmir Valley. Int J Dev Res. 2018;8:19559–62.
12. Ganie MA, Sahar T, Rashid A, Baba MS, Ahmad N, Bhat H, et al. Prevalence of diabetes and prediabetes in tribal population of Kashmir:Lessons for the future. Diabetes Res Clin Pract. 2020;169:108457.
13. Vitezova A, Muka T, Zillikens MC, Voortman T, Uitterlinden AG, Hofman A, et al. Vitamin D and body composition in the elderly. Clin Nutr. 2017;36:585–92.
14. Horas, K., Hoxha, M., Heinz, T., Jakuscheit, A., List, K., Maier, G. S., Weißenberger, M., & Rudert, M. (2024). Prevalence and Risk Factors of Vitamin D Deficiency in Patients Scheduled to Undergo Revision Arthroplasty of the Hip, Knee and Shoulder—Data from a Single-Centre Analysis. Nutrients, 16(18), 3060. https://doi.org/10.3390/nu16183060
15. Liu, C.; Seyok, T.; Moye, S.; Sugita, L.; Eltouny, E.; Carrera, C.; Denagamage, P.; Charles, J.; Fitz, W.; Chen, A.F.; et al. High rates of vitamin D insufficiency among patients presenting for total knee arthroplasty. J. Orthop. Res. Off. Publ. Orthop. Res. Soc. 2024, 42, 1501–1508.
16. Jeon, Y.D.; Cho, S.D.; Youm, Y.S.; Song, J.Y.; Lee, K.J.; Park, K.B. The Prevalence of Vitamin D Deficiency in Patients Undergoing Total Knee Arthroplasty: A Propensity Score Matching Analysis. Arch. Osteoporos. 2022, 17, 53.
17. Emara, A.K.; Nageeb, E.; George, J.; Buttaro, M.A.; Higuera, C.; Piuzzi, N.S. Hypovitaminosis D in lower extremity Joint Arthroplasty: A systematic review and meta-analysis. J. Orthop. 2020, 21, 109–116.
18. MacConnell, A.E.; Anderson, J.; Stanila, T.; Shivdasani, K.; Hand, R.; Boubekri, A.; Garbis, N.; Salazar, D. The effect of vitamin D insufficiency on outcomes and complication rates after shoulder arthroplasty: A single center retrospective examination. Semin. Arthroplast. JSES 2024, 34, 182–189.
19. Duggan, J.L.; Fitz, W.; Lange, J.K.; Shah, V.M.; Olsen, A.; Iorio, R.; Chen, A.F. Postoperative Vitamin D Surveillance and Supplementation in Revision Total Knee Arthroplasty Patients: A Retrospective Cohort Analysis. Orthop. Clin. N. Am. 2024, 55, 323–332.
20. Mouli, V.H.; Schudrowitz, N.; Carrera, C.X.; Uzosike, A.C.; Fitz, W.; Rajaee, S.S. High-Dose Vitamin D Supplementation Can Correct Hypovitaminosis D Prior to Total Knee Arthroplasty. J. Arthroplast. 2022, 37, 274–278.
21. Morrison, R.J.M.; Fishley, W.G.; Rankin, K.S.; Reed, M.R. The effect of vitamin D supplementation on outcomes following total hip or knee arthroplasty surgery: A rapid systematic review of current evidence. EFORT Open Rev. 2022, 7, 305–311.
22. Alzohily, B.; AlMenhali, A.; Gariballa, S.; Munawar, N.; Yasin, J.; Shah, I. Unraveling the complex interplay between obesity and vitamin D metabolism. Sci. Rep. 2024, 14, 7583.