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

Abstract

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.

Osteochondral Lesions of the Talus: A Review on Talus Osteochondral Injuries, Including Osteochondritis Dissecans

“…Maier et al 42 demonstrated a severe and significant vitamin D 3 deficiency in 97.5% of their 80 patients suffering from juvenile OCD (JOCD) when compared with patients not suffering from such lesions. Fraissler et al 43 found similar results in talar lesions in both: in patients suffering from a traumatic OLT and in those having a nontraumatic one.…”

The role of vitamin D and vitamin D deficiency in orthopaedics and traumatology—a narrative overview of the literature

“…Numerous studies have reported low vitamin D levels in orthopaedic patients (24,74,75). Furthermore, insufficient vitamin D levels have also been described in pediatric orthopaedic patients (38,76).…”

“…In general, a great number of orthopaedic patients undergoing surgery have been identified to be vitamin D insufficient. These include patients scheduled for foot and ankle, spine, knee, shoulder and elbow surgery as well as arthroplasty including hip, knee and shoulder arthroplasty (12,24,75,77,78). Several orthopaedic diseases have also been associated with low vitamin D levels (79).…”

“…For example, it has been demonstrated that patients with decreased articular cartilage thickness were more likely to be vitamin D insufficient and, thus, low vitamin D status might be a risk factor for the development of osteoarthritis (3). Furthermore, orthopaedic diseases that are associated with alterations of bone metabolism, such as bone marrow oedema syndrome and osteochondritis dissecans have been linked to low vitamin D levels (23,75).…”

Electromagnetic Navigation Reduces Radiation Exposure and Provides Excellent Accuracy for Retrograde Drilling in Osteochondrosis Dissecans of the Talus

“…[5] In contrast to adults, spontaneous healing of talar OCD has been documented in children [6]. In stable OCD, non-surgical treatment includes abstinence of certain sports and compression loads as well as adjustment of vitamin D levels [7,8]. An e cient and commonly employed surgical therapy of nearly unstable OCD is arthroscopically-assisted drilling for subchondral decompression and revascularization [9][10][11][12][13].…”