Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Vitamin D-ficiency Common among Orthopaedic Surgery Patients

07.10.2010
New Study Finds Nearly Half of Patients Have Low Vitamin D Levels Authors Recommend Screening, Supplementation to Improve Post-Surgical Healing

Forty-three percent of patients scheduled to undergo orthopaedic surgery have insufficient levels of vitamin D and two out of five of those patients had levels low enough to place them at risk for metabolic bone disease, according to a study published this month in the October 6th issue of the Journal of Bone and Joint Surgery (JBJS).

According to the National Institutes of Health (NIH) , vitamin D helps the body absorb calcium and is essential for bone growth and bone remodeling. Without sufficient vitamin D, bones can become thin, brittle or misshapen. People can obtain vitamin D in three ways:

by eating certain types of food (including fish, dairy products, eggs and mushrooms);

receiving sun exposure; and

taking supplements

“Given the importance of vitamin D in musculoskeletal health and its role in bone healing following orthopaedic procedures, low levels may negatively impact patient outcomes,” said orthopaedic surgeon Joseph M. Lane, MD, study co-author and chief of the metabolic bone disease service at the Hospital for Special Surgery in New York.

All 723 patients in the study had been cleared by a specialist in internal medicine for elective surgery in one of the following orthopaedic service areas: Trauma, Foot and Ankle, Sports Medicine (only ACL and/or meniscal repair), Arthroplasty (only primary total hip and knee replacement), Hand (only distal radial or ulnar fracture) and Metabolic Bone Disease (only vertebral compression fracture).

The researchers found that, of the 723 patients studied,

411 (57 percent) had normal Vitamin D levels,

202 (28 percent) had insufficient levels; and

110 (15 percent) were vitamin D deficient.

“We found that nearly half of the patients who were considered ‘healthy’ enough for surgery had significantly low levels of vitamin D, placing them at risk for poor bone healing, osteomalacia (bone and muscle weakness) or even secondary hyperparathyroidism (increased secretion of the parathyroid hormone) in the most severe cases,” said Dr. Lane, who is also a professor of orthopedic surgery at Weill Cornell Medical College in New York. “This was very disconcerting since vitamin D levels can be determined with a simple blood test and low levels can be easily treated with supplements in just a few weeks.”

When results were broken down by orthopaedic service area, researchers uncovered a surprising finding: Despite having the youngest mean population (age 45 ± 14.9 years), the Sports Medicine group of patients had the second-highest rate of vitamin D insufficiency (52 percent) – exceeded only by patients in the Trauma group (66.1 percent). The remaining groups had insufficiency levels of 40 percent (Hand), 38 percent (Arthroplasty), 34 percent (Foot and Ankle) and 18.6 percent (Metabolic Bone Disease).

The researchers noted that their results are consistent with those of similar studies investigating the prevalence of vitamin D deficiency in the general population, including identification of risk factors including obesity and dark skin tone.

“This study should serve as a wake-up call to orthopedists that vitamin D deficiency is widespread, not necessarily tied to age, sex or background and screening for it should be part of routine pre-surgical care for adults,” said Dr. Lane. “Meanwhile, patients who are planning to undergo any orthopaedic procedure can request a screening (specifically, a blood test called the 25 hydroxy Vitamin D test) or ask to be placed on a medically supervised Vitamin D supplement regimen prior to surgery.”

Study specific details:
In a retrospective chart review, Dr. Lane and his colleagues measured Vitamin D levels of 723 patients who were scheduled for orthopaedic surgery between January 2007 and March 2008 and determined the prevalence of normal, insufficient and deficient levels according to the following parameters:

Normal: equal to or greater than 32 nanograms per milliliter (ng/mL)

Insufficient: less than 32 ng/mL

Deficient: less than 20 ng/mL

How much Vitamin D does the skin make? Our skin makes a lot of Vitamin D when we spend time in strong sunlight. With about 5-30 minutes of sunlight exposure of head, face, hands, arms, or legs), our skin can make about 1000 IUs of Vitamin D (Vitamin D is measured in units called "International Units," or IUs.) Vitamin D is therefore known as "the sunshine vitamin." However, as you age you can lose your ability to manufacture Vitamin D through sunlight.

How much Vitamin D is enough? The American Academy of Orthopaedic Surgeons (AAOS) and recent research support that the body needs at least 1000 IU per day for good health — depending on age, weight, and growth. Indeed, many people need much more than 1000 IU to keep Vitamin D levels in a good range.

In general, babies (especially mothers who are breastfeeding) and small children should intake at least 400 IU of Vitamin D daily. Children over age 5, adolescents, and adults should get a minimum of 1000 IU of Vitamin D each day.

Disclosure: The HSS study was supported by funding from the Cohn Foundation and the Weill-Cornell Clinical Translation Science Center (UL1RR024996-01). Dr. Lane and his co-authors received no compensation for their research.

About the American Academy of Orthopaedic Surgeons (AAOS)

www.orthoinfo.org

AAOS on Facebook and Twitter

NIH Office of Dietary Supplements, “Dietary Supplement Fact Sheet: Vitamin D,” http://ods.od.nih.gov/factsheets/vitamind.asp

Lauren L. Pearson | EurekAlert!
Further information:
http://www.aaos.org

More articles from Health and Medicine:

nachricht 'Living bandages': NUST MISIS scientists develop biocompatible anti-burn nanofibers
16.02.2018 | National University of Science and Technology MISIS

nachricht New process allows tailor-made malaria research
16.02.2018 | Eberhard Karls Universität Tübingen

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: In best circles: First integrated circuit from self-assembled polymer

For the first time, a team of researchers at the Max-Planck Institute (MPI) for Polymer Research in Mainz, Germany, has succeeded in making an integrated circuit (IC) from just a monolayer of a semiconducting polymer via a bottom-up, self-assembly approach.

In the self-assembly process, the semiconducting polymer arranges itself into an ordered monolayer in a transistor. The transistors are binary switches used...

Im Focus: Demonstration of a single molecule piezoelectric effect

Breakthrough provides a new concept of the design of molecular motors, sensors and electricity generators at nanoscale

Researchers from the Institute of Organic Chemistry and Biochemistry of the CAS (IOCB Prague), Institute of Physics of the CAS (IP CAS) and Palacký University...

Im Focus: Hybrid optics bring color imaging using ultrathin metalenses into focus

For photographers and scientists, lenses are lifesavers. They reflect and refract light, making possible the imaging systems that drive discovery through the microscope and preserve history through cameras.

But today's glass-based lenses are bulky and resist miniaturization. Next-generation technologies, such as ultrathin cameras or tiny microscopes, require...

Im Focus: Stem cell divisions in the adult brain seen for the first time

Scientists from the University of Zurich have succeeded for the first time in tracking individual stem cells and their neuronal progeny over months within the intact adult brain. This study sheds light on how new neurons are produced throughout life.

The generation of new nerve cells was once thought to taper off at the end of embryonic development. However, recent research has shown that the adult brain...

Im Focus: Interference as a new method for cooling quantum devices

Theoretical physicists propose to use negative interference to control heat flow in quantum devices. Study published in Physical Review Letters

Quantum computer parts are sensitive and need to be cooled to very low temperatures. Their tiny size makes them particularly susceptible to a temperature...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

2nd International Conference on High Temperature Shape Memory Alloys (HTSMAs)

15.02.2018 | Event News

Aachen DC Grid Summit 2018

13.02.2018 | Event News

How Global Climate Policy Can Learn from the Energy Transition

12.02.2018 | Event News

 
Latest News

New tech for commercial Lithium-ion batteries finds they can be charged 5 times fast

20.02.2018 | Power and Electrical Engineering

Hidden talents: Converting heat into electricity with pencil and paper

20.02.2018 | Materials Sciences

Rare find from the deep sea

20.02.2018 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>