Vitamin d is related to gait recovery after total hip arthroplasty: A prospective analysis

Cunha, Bernardo Matos da; Gava, Aline Dalfito; Oliveira, Sandro Barbosa de; David, Ana Cristina de; Santos-Neto, Leopoldo Luiz dos

doi:10.1016/j.gaitpost.2016.08.014

Cited by 14 publications

(14 citation statements)

References 28 publications

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“…The change in the TUG did not differ between the 2 groups, likewise in our study. Lastly, a study among 110 Brazilian patients also found that gait speed recovered after THA but unrelated to serum 25(OH)D 3 concentrations [33], which corresponded with our results.…”

Section: Discussionsupporting

confidence: 91%

Association Between Preoperative Vitamin D Status and Short-Term Physical Performance after Total Hip Arthroplasty: A Prospective Study

Visser¹,

Roos²,

Oosting³

et al. 2018

Ann Nutr Metab

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Background: Insufficient serum vitamin D concentrations (50–75 nmol/L) are prevalent in 40–65% of patients who require total hip arthroplasty (THA). This could impair physical recovery after surgery. This study investigated the association between preoperative vitamin D status and physical performance after THA. Additionally, postoperative changes in vitamin D concentrations were measured. Methods: We included 87 patients scheduled for elective THA and aged ≥65 years. Three groups were recruited: patients classified as vitamin D deficient (< 50 nmol/L, n = 23), insufficient (50–75 nmol/L, n = 32), or sufficient (> 75 nmol/L, n = 32). Serum 25-hydroxyvitamin D₃ (25[OH]D₃) concentration and physical performance were measured perioperatively. Linear mixed models were used to examine differences between groups. Results: Change in physical performance over time was not affected by preoperative vitamin D status. In contrast, for physical activity, both vitamin D (p = 0.021) and time (p < 0.001) effect was seen: from 80.2 ± 25.8 to 58.1 ± 17.8 min/day in the deficient group, 143.7 ± 19.8 to 92.9 ± 11.5 min/day in the insufficient group, and 108.1 ± 20.9 to 62.3 ± 12.9 min/day in the sufficient group. The Chair Stand Test, Timed Up and Go test, and 10-Meter Walking Test also improved significantly over time, but independent of vitamin D status. An increase in 25(OH)D₃ concentration 6 weeks postoperatively was correlated with improved hip function (Pearson’s r = –0.471, p = 0.018). Overall, serum 25(OH)D₃ declined with 32% one day after surgery (p < 0.001), to nearly return to baseline values 6 weeks later in all groups. Conclusion: Vitamin D status did not appear to affect physical recovery after THA. The drop in vitamin D after surgery deserves further investigation, but could possibly be explained by hemodilution.

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Section: Discussionsupporting

confidence: 91%

Association Between Preoperative Vitamin D Status and Short-Term Physical Performance after Total Hip Arthroplasty: A Prospective Study

Visser¹,

Roos²,

Oosting³

et al. 2018

Ann Nutr Metab

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“…Five studies were of high methodological quality, 11 , 14 , 15 , 18 , 21 12 were of moderate quality 12 , 13 , 16 , 17 , 19 , 20 , 22 - 25 , 27 , 28 and 1 of low quality. 26 …”

Section: Resultsmentioning

confidence: 99%

“…In total, 18 studies were included in the systematic review. 11 – 28 Details of the study screening and selection are displayed in the flowchart of Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“…The mean reported age of the patients ranged from 59.4 to 76 years. Seventeen studies reported on the prevalence of hypovitaminosis D; 11 – 23 , 25 – 28 2598 out of 9720 (26.7%) patients were diagnosed with low vitamin D levels. The detailed descriptive characteristics of the included studies are presented in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…The crucial role of vitamin D in optimizing the mechanical loading through its effect on muscle function and bone turnover has also been evaluated in the outcomes of total joint arthroplasty (TJA). 11 – 28 A high prevalence of vitamin D deficiency is recorded among patients undergoing TJA due to osteoarthritis, giving rise to the hypothesis that perioperative levels of vitamin D might play a role in patients undergoing lower limb arthroplasty. 29 , 30 Several studies have reported a correlation between vitamin D levels and functional status as well as the risk of complications following TJA with conflicting outcomes.…”

Section: Introductionmentioning

confidence: 99%

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<p>The Effect of Perioperative Vitamin D Levels on the Functional, Patient-Related Outcome Measures and the Risk of Infection Following Hip and Knee Arthroplasty: A Systematic Review</p>

Kenanidis

Kakoulidis

Karponis

et al. 2020

PROM

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Introduction The aim of this study was to evaluate the effect of perioperative vitamin D levels in terms of functional results, patient-related outcome measures (PROMs) and infection risk after hip or knee replacement. Materials and Methods A systematic search in PubMed, Cochrane library, ScienceDirect and ClinicalTrials.gov was conducted according to the PRISMA guidelines from inception to January 2020. Results Eighteen studies with more than 8000 knee and 1500 hip joint arthroplasties were included. The mean follow-up ranged from 6 weeks to 1 year and mean patients’ age from 59.4 to 76 years. Hypovitaminosis was diagnosed in 26.7% of cases. Most studies did not find significant differences in pre- and postoperative functional results, PROMs and length of hospital stay between hypovitaminosis and euvitaminosis groups. Deficient patients may be at higher risk of postoperative joint stiffness. Patients suffering from hip and knee periprosthetic joint infection seem to have lower vitamin D levels compared to those with aseptic loosening of implants. Conclusion The necessity of pre-operative correction of vitamin D levels to achieve better functional results and minimize the risk of infection following hip and knee arthroplasty remains inconclusive. Extend of exposure to low vitamin D levels and comparison between outliers needs further evaluation.

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High rates of vitamin D insufficiency among patients presenting for total knee arthroplasty

Liu,

Seyok,

Moye

et al. 2024

Journal Orthopaedic Research

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Widely varying prevalence of vitamin D deficiency has been reported in patients presenting for total knee arthroplasty (TKA). The primary aim of this study was to determine vitamin D levels in TKA patients and to compare to patients already routinely evaluated for vitamin D levels, patients with fragility fractures of the distal radius (DRF). There is significant overlap between patients presenting for TKA and with DRF, both in terms of medical comorbidities and overall health status, making these populations suitable comparative cohorts. Wefound that all patients presenting for TKA consultation had vitamin D insufficiency and 33% had vitamin D deficiency, compared to only 37% and 14% in the DRF cohort, a patient population routinely evaluated for vitamin D due to the high risk of deficiency. Furthermore, patients with DRF had higher levels of vitamin D before (38 ± 16 vs. 23 ± 5) and after vitamin D supplementation (39 ± 17 vs. 33 ± 10), suggesting that patients presenting for TKA are at even higher risk of vitamin D insufficiency than patients presenting with DRF. Reassuringly, supplementation successfully corrected 39.0% and 55.8% of patients in the DRF and TKA cohorts, respectively.

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Vitamin d is related to gait recovery after total hip arthroplasty: A prospective analysis

Cited by 14 publications

References 28 publications

Association Between Preoperative Vitamin D Status and Short-Term Physical Performance after Total Hip Arthroplasty: A Prospective Study

Association Between Preoperative Vitamin D Status and Short-Term Physical Performance after Total Hip Arthroplasty: A Prospective Study

<p>The Effect of Perioperative Vitamin D Levels on the Functional, Patient-Related Outcome Measures and the Risk of Infection Following Hip and Knee Arthroplasty: A Systematic Review</p>

High rates of vitamin D insufficiency among patients presenting for total knee arthroplasty

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