Prevalence of Vitamin D Deficiency in Patients With Talar Osteochondral Lesions

Telleria, Jessica J.M.; Ready, Lauren V.; Bluman, Eric M.; Chiodo, Christopher P.; Smith, Jeremy T.

doi:10.1177/1071100717745501

Cited by 16 publications

(8 citation statements)

References 39 publications

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“…14 A high rate of vitamin D deficiency or hypovitaminosis D was also identified in patients with OLT and juvenile osteochondritis dissecans. 21,27 Vitamin D deficiency is potentially an important cofactor in the multifactorial development of osteochondritis dissecans. 27 Adolescent participants often have vitamin D insufficiency, and serum vitamin D levels below 20 ng/mL were observed in 64.8% of adolescent girls and 52.1% of adolescent boys.…”

Section: Discussionmentioning

confidence: 99%

“…21,27 Vitamin D deficiency is potentially an important cofactor in the multifactorial development of osteochondritis dissecans. 27 Adolescent participants often have vitamin D insufficiency, and serum vitamin D levels below 20 ng/mL were observed in 64.8% of adolescent girls and 52.1% of adolescent boys. 2 Although serum vitamin D level was not measured in this study, they might have had vitamin D insufficiency because the subjects were juvenile OLT patients.…”

Section: Discussionmentioning

confidence: 99%

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Retrograde Drilling for Osteochondral Lesion of the Talus in Juvenile Patients

Ikuta

Nakasa

Ota

et al. 2020

Foot & Ankle Orthopaedics

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Background: Retrograde drilling (RD) is generally used for treating osteochondral lesion of the talus (OLT) with a stable osteochondral fragment and nearly normal articular cartilage surface. Previous studies that included participants of various ages have reported good clinical results. This study aimed to clarify the clinical outcomes of RD for OLT in juvenile patients whose bone-forming ability and physical activity might affect the healing process. Methods: This retrospective study included 8 juvenile patients who underwent RD for OLT (5 boys and 3 girls, mean age 14.9 years, mean follow-up 2 years, 7 medial and 1 central lesion). American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score and ankle activity score were evaluated, and arthroscopic findings were graded according to the International Cartilage Research Society (ICRS) classification system. The condition of the underlying bone was assessed on preoperative computed tomographic images. The stability, incorporation, and subsidence of the osteochondral fragment, articular surface congruity, and the area of the bone marrow lesion (BML) were evaluated using magnetic resonance imaging (MRI). Results: AOFAS ankle-hindfoot score and ankle activity score significantly improved postoperatively. Arthroscopically, the lesions were classified as ICRS grade 0 or 1. Bone sclerosis or multiple small cysts of the underlying bone were observed in all patients. MRI demonstrated no signs of osteochondral fragment instability or subsidence, good or fair fragment incorporation, good articular surface congruity, or slight irregularity. The postoperative BML was reduced; however, these BMLs were still detectable at 1 year after surgery. Conclusion: Our data suggested that RD is an option for treating juvenile patients with OLT refractory to nonoperative treatment at short-term follow-up. Although bone sclerosis or multiple small cysts were identified in the underlying bone preoperatively and the BML under the osteochondral fragment remained postoperatively, clinical status such as pain and physical activity level were improved by RD. Level of Evidence: Level IV, retrospective case series.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Retrograde Drilling for Osteochondral Lesion of the Talus in Juvenile Patients

Ikuta

Nakasa

Ota

et al. 2020

Foot & Ankle Orthopaedics

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“…In addition, in situations where the underlying bony architecture is further weakened, such as occurs with decreased bone mineral density, the risk for mechanical failure is even higher. 33 Consequently, altered bony microarchitecture due to vitamin D deficiency might lead to more severe OCD of the talus. For this reason, we further analyzed the cohort for a possible correlation between vitamin D levels and the degree of OCD as analyzed in MR imaging.…”

Section: Discussionmentioning

confidence: 99%

“…20,23,30 Moreover, we and others have shown that vitamin D deficiency also affects patients with foot and ankle disorders. 1,16,32,33 Further, it has been suggested that hypo-vitaminosis D is related to the onset of OCD. 25,33 However, data on the vitamin D status of patients with OCD are scarce and to date mostly limited to measurements in adolescents.…”

mentioning

confidence: 99%

“…1,16,32,33 Further, it has been suggested that hypo-vitaminosis D is related to the onset of OCD. 25,33 However, data on the vitamin D status of patients with OCD are scarce and to date mostly limited to measurements in adolescents. For this reason, the purposes of this study were to identify the prevalence of vitamin D deficiency in patients of all ages with OCD of the talus; to elucidate whether or not there are differences in prediagnostic vitamin D, parathyroid hormone (PTH), or serum calcium status in patients with previously reported trauma compared with patients with idiopathic OCD; and to detect a potential correlation between a patient’s vitamin D status and the degree of OCD of the talus.…”

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confidence: 99%

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Vitamin D Deficiency in Patients With Idiopathic and Traumatic Osteochondritis Dissecans of the Talus

et al. 2019

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Background: Low vitamin D levels are common in patients with foot and ankle disorders. We have previously demonstrated that juveniles diagnosed with osteochondritis dissecans (OCD) have a high prevalence of vitamin D deficiency. Moreover, there is evidence that OCD might be related to vitamin D deficiency in general. However, whether or not hypovitaminosis D is associated with OCD of the talus has yet to be elucidated. Methods: The aim of this study was to determine serum vitamin D levels [25(OH)D] of patients diagnosed with traumatic and idiopathic OCD of the talus. The vitamin D status of patients was measured and correlated to age, sex, season, etiology, laterality, degree of disease, and nicotine abuse. Moreover, parathyroid hormone and serum calcium levels of patients were obtained to assess for severe vitamin D deficiency and secondary hyperparathyroidism. Between January 2015 and December 2017, 65 patients with a mean age of 38.9 years and a total of 68 lesions were identified. Results: In total, 75.4% of patients had low vitamin D levels with a mean overall 25(OH)D level of 24.2 ng/mL. Specifically, 35.4% of patients were vitamin D deficient; another 40% were vitamin D insufficient, and only 24.6% of patients presented with sufficient vitamin D levels. Statistical analysis showed no significant difference comparing vitamin D levels of patients with idiopathic OCD to patients with traumatic OCD. Conclusion: We could not find any significant differences in the vitamin D status of patients with OCD of the talus compared with patients with foot and ankle disorders in general. However, we found that vitamin D deficiency was frequent in patients presenting with traumatic and idiopathic OCD of the talus. We believe it might be beneficial to routinely assess and treat the vitamin D status of patients. Level of Evidence: Level III, retrospective comparative study.

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