Fewer Complications Following Revision Hip and Knee Arthroplasty in Patients with Normal Vitamin D Levels

Created March 2017

 

The Journal of Arthroplasty, online 8 March 2017, http://dx.doi.org/10.1016/j.arth.2017.02.038

Sophia Traven, MD1, , , Alexander Chiaramonti, MD1, William Barfield, PhD1, Patricia Kirkland, BS1, Harry Demos, MD1, H. Del Schutte, MD2, Jacob Drew, MD1

 

* Search VitaminDWiki for (Hip OR Knee) Arthroplasty 143 hits as of May 2018 * Knee Arthroplasty complications were 2 X more likely if low vitamin D -May 2018 * Total hip replacement: 14 times more likely to redo if low vitamin D – March 2017 - free ! * 4 fewer days in hospital after hip or knee replacement if good level of vitamin D – June 2016 * Surgical outcomes are better for higher levels of Vitamin D – systematic review May 2015 * Vitamin D insufficiency increased after hip replacement: – 38% before, 68% the next day – Nov 2016 1. # Having enough vitamin D minimizes the need for hip/knee replacement * Hip fracture 50 percent more likely if low in both vitamin D and vitamin K1 – Dec 2015 * Hip fracture 3X more likely if low vitamin D – Dec 2015 * Knee joint space narrowing (Osteoarthritis) 1.5X worse with low vitamin D – meta-analysis Sept 2015 * Knee pain in seniors predicted by low vitamin D 5 years before – Feb 2014 * Hip fractures reduced 2X to 6X with just 10 minutes of sunlight daily – RCT 2003-2010

Background

Surgeons and hospitals increasingly face penalty for complications and readmission following total joint arthroplasty (TJA), therefore optimization of modifiable risk factors is paramount. Literature associates low vitamin D with risk of periprosthetic joint infection (PJI), and we hypothesized low vitamin D to be predictive of increased rate of complications and readmissions.

Methods

A retrospective review of 126 revision TJA patients between 2010-2014 was performed.

Results

Low vitamin D was not associated with risk of 30-day readmission, but was found to be associated with an increased risk of 90-day complications as well as PJI as the reason for revision surgery.

Conclusions

Preoperative vitamin D level should be considered a modifiable risk factor for complications following revision arthroplasty.

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Tags: Trauma and surgery