Background: The importance of appropriate serum 25-hydroxy vitamin D [25(OH)D] for multiple health measures is widely described, however, the prevalence of vitamin D deficiency remains remarkably high. The goal of our study is to explore the distribution of vitamin D deficiency among an elective total joint arthroplasty (TJA) population within a lower latitude climate with relatively abundant sunshine. We hypothesize this group will demonstrate a high prevalence of vitamin D deficiency, thus exposing a potential opportunity to improve outcomes with proper identification and management.Methods: From January to December, 2014, serum 25(OH)D levels were collected during a standard preoperative workup prior to primary or revision joint arthroplasty in South Carolina. Mean serum 25(OH)D, seasonal variation, and patient demographics were recorded. We defined Vitamin D deficiency consistent with the current Endocrine Society classification: serum 25(OH)D < 20 ng/ml, 21-29 ng/ml, and 30-100 ng/ml representing deficiency, insufficiency, and normal, respectively.Results: A total of 308 patients underwent evaluation. 46.8% (144) of the participants were female, and 89.6% (276) identified as Caucasian. The mean patient age was 68.3 years ±13.8 (32-88

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