High-Dose Vitamin D Supplementation Can Correct Hypovitaminosis D Prior to Total Knee Arthroplasty

Mouli, Vibav H.; Schudrowitz, Natalie; Carrera, Christopher X.; Uzosike, Akachimere; Fitz, Wolfgang; Rajaee, Sean S.

doi:10.1016/j.arth.2021.10.016

Cited by 15 publications

(22 citation statements)

References 31 publications

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“…Vitamin D deficiency was detected in 64 participants before the TKA (25-hydroxyvitamin D < 30 ng/mL), but after 3 months of supplementation, all functional results were similar to those in patients without preoperative deficiencies [ 18 ]. The need for vitamin D supplementation in postoperative patients has also been emphasized by Mouli et al (2022) [ 19 ], who carried out a retrospective analysis of 174 patients with vitamin D (25(OH)D) deficiency at a level <30 ng/mL. Participants were administered preparations according to the following schedule: daily supplementation of vitamin D3 (from 1000 to 6000 IU) or a loading dose of 50,000 IU weekly for 4 weeks, and then 2000 IU/d.…”

Section: Resultsmentioning

confidence: 99%

“…Participants were administered preparations according to the following schedule: daily supplementation of vitamin D3 (from 1000 to 6000 IU) or a loading dose of 50,000 IU weekly for 4 weeks, and then 2000 IU/d. The authors concluded that the second approach is more effective in correcting vitamin D deficiency; thus, supplementation should be used in patients prior to TKA [ 19 ].…”

Section: Resultsmentioning

confidence: 99%

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Vitamin D Metabolic Pathway Components in Orthopedic Patientes—Systematic Review

Płomiński

Grzybowski

Fiedorowicz

et al. 2022

IJMS

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Vitamin D takes part in the functioning of many processes that ensure the homeostasis of the body. In orthopedics, it is indicated as an inseparable element ensuring proper bone growth and functioning, and its deficiencies are indicated in various diseases, mainly in the proper structure and function of the skeleton. In this review, we focus on the most important components of the vitamin D metabolic pathway, in correlation with selected orthopedic conditions. Records were obtained from the PubMed database in a timeline of 2010–2022. The keywords were as follows: vitamin D/cholesterol/vitamin D binding protein/ VDBP/Cytochrome/CYP24A1/CYP 27B1/Vitamin D receptor/VDR/ + diseases (ACL reconstruction, rotator cuff, arthroplasty knee/hip/shoulder). The recent original studies were analyzed, discussed, and the most important data were shown. The vast majority of articles concern the metabolite of vitamin D (25(OH)D), which is measured as a standard in diagnostic laboratories. Even though there is a lot of valuable information in the literature, we believe that the other elements of the vitamin D pathway also deserve attention and suggest their research in correlation with orthopedic disorders to supplement the missing knowledge on this topic.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Vitamin D Metabolic Pathway Components in Orthopedic Patientes—Systematic Review

Płomiński

Grzybowski

Fiedorowicz

et al. 2022

IJMS

View full text Add to dashboard Cite

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“…4 Similarly, hypovitaminosis D 2 (<30 ng/mL) has been linked to increased 90-day complications after TJA, including higher rates of PJI, unplanned revision surgery, and venous thromboembolism. 24,25 In one study, low vitamin D 2 was an independent predictor of increased falls after total knee arthroplasty (TKA). 25 Of note, in addition to its role in calcium homeostasis, vitamin D 2 also contributes to immunomodulation, vascular remodeling, and wound healing.…”

Section: Screening For Malnutritionmentioning

confidence: 99%

“…25 An investigation of the most appropriate regimen for correcting low vitamin D 2 (<30 ng/mL) before TKA found that a loading dose of 50,000 IU of vitamin D 3 weekly for 4 weeks, followed by a maintenance dose of 2,000 IU/d, was superior to a daily low-dose regimen. 24 This was achieved with little expense, with an average cost of screening of $55.72 and cost of high-dose repletion $17.87. 24 Although postoperative complications were not reported, this dose represents at least six times less than the minimum dose at which hypercalcemia has been described.…”

Section: Management Considerationsmentioning

confidence: 99%

Screening and Management of Malnutrition in Total Joint Arthroplasty

Phillips

Ennis

Dennis

2023

J Am Acad Orthop Surg

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Malnutrition is an increasingly prevalent problem in patients undergoing total joint arthroplasty (TJA). Increased risks associated with TJA in the setting of malnourishment have been well documented. Standardized scoring systems in addition to laboratory parameters such as albumin, prealbumin, transferrin, and total lymphocyte count have been developed to identify and evaluate malnourished patients. Despite an abundance of recent literature, there is no consensus on the best approach for screening TJA patients from a nutritional standpoint. Although there are a variety of treatment options, including nutritional supplements, nonsurgical weight loss therapies, bariatric surgery, and the involvement of dieticians and nutritionists, the effect of these interventions on TJA outcomes has not been well characterized. This overview of the most current literature aims to provide a clinical framework for approaching nutrition status in arthroplasty patients. A comprehensive understanding of the tools available for managing malnourishment will facilitate improved arthroplasty care.

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“…Mouli et al carried out a similar study, including 174 patients with vitamin D deficit (<30 ng/mL) who received vitamin D antioxidant therapy with the following protocol: (1) daily vitamin D supplementation with an increasing dose between 1000 and 6000 IU and (2) one weekly dose of 50,000 IU, administered for four weeks, followed by the maintenance of a daily dose of 2000 IU. In the surgical patients included in the study, the authors recommended a vitamin D antioxidant therapy with 50,000 IU of vitamin D weekly for four weeks, followed by a maintenance dose, as a better solution than the administration of lower, daily doses [ 241 ]. Hajimohammadebrahim-Ketabforoush et al studied the impact of vitamin D administration in deficient patients that had undergone craniectomy for brain tumor resection.…”

Section: Perioperative Antioxidant Therapymentioning

confidence: 99%

The Impact of General Anesthesia on Redox Stability and Epigenetic Inflammation Pathways: Crosstalk on Perioperative Antioxidant Therapy

Ritiu

Rogobete

Săndesc

et al. 2022

Cells

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Worldwide, the prevalence of surgery under general anesthesia has significantly increased, both because of modern anesthetic and pain-control techniques and because of better diagnosis and the increased complexity of surgical techniques. Apart from developing new concepts in the surgical field, researchers and clinicians are now working on minimizing the impact of surgical trauma and offering minimal invasive procedures due to the recent discoveries in the field of cellular and molecular mechanisms that have revealed a systemic inflammatory and pro-oxidative impact not only in the perioperative period but also in the long term, contributing to more difficult recovery, increased morbidity and mortality, and a negative financial impact. Detailed molecular and cellular analysis has shown an overproduction of inflammatory and pro-oxidative species, responsible for augmenting the systemic inflammatory status and making postoperative recovery more difficult. Moreover, there are a series of changes in certain epigenetic structures, the most important being the microRNAs. This review describes the most important molecular and cellular mechanisms that impact the surgical patient undergoing general anesthesia, and it presents a series of antioxidant therapies that can reduce systemic inflammation.

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High-Dose Vitamin D Supplementation Can Correct Hypovitaminosis D Prior to Total Knee Arthroplasty

Cited by 15 publications

References 31 publications

Vitamin D Metabolic Pathway Components in Orthopedic Patientes—Systematic Review

Vitamin D Metabolic Pathway Components in Orthopedic Patientes—Systematic Review

Screening and Management of Malnutrition in Total Joint Arthroplasty

The Impact of General Anesthesia on Redox Stability and Epigenetic Inflammation Pathways: Crosstalk on Perioperative Antioxidant Therapy

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