Vitamin D Deficiency Is Damaging For Patients Recovering From Orthopedic Surgery

Vitamin D is essential for bone healing and muscle function and is critical for a patient’s recovery...

However, nearly HALF of all patients undergoing orthopedic surgery have vitamin D deficiency. This critical deficiency should be corrected before surgery to improve patient outcomes, according to a study by researchers at Hospital for Special Surgery (HSS) in New York City. The study appears in the October issue of The Journal of Bone and Joint Surgery.
According to the researchers, bone tissue formation (bone remodeling) is a major part of the healing process, occurs about two to four weeks after surgery. This is the critical stage when the body needs vitamin D.

For their study, investigators conducted a retrospective chart review of 723 patients who were scheduled for orthopedic surgery between January 2007 and March 2008 at HSS. They examined the vitamin D levels, which had been measured in all patients before their surgery, and found that 43 percent had insufficient vitamin D and 40 percent had deficient levels.

The highest levels of deficiency were seen in patients in the trauma service, where 66 percent of patients had insufficient levels and 52 percent had deficient levels. Of the patients undergoing foot and ankle surgery, 34 percent had inadequate levels and of patients undergoing hand surgery, 40 percent had insufficient levels.

In the Sports Medicine Service, 52.3 percent had insufficient levels and of these, one-third of these or 17 percent of the total had deficient levels. “We frequently see stress fractures in the Sports Medicine Service and if you want to heal, you have to fix the calcium and vitamin D,” the doctors reported.

In the Arthroplasty Service, which conducts hip and knee replacements, 38 percent had inadequate levels and 48 percent had deficient levels. “With arthroplasty, there is a certain number of patients that when you put in the prothesis, it breaks the bone adjacent to the prostheses, which can really debilitate patients.”

This could be prevented or minimized by correcting vitamin D levels. They also explained that they now perform procedures where they grow a bone into a prosthesis without using cement. “In those people, it would be an advantage to have adequate vitamin D, because it matures the bone as it grows in, it is really healing into the prosthesis,” they said. “We recommend that people undergoing a procedure that involves the bone or the muscle should correct their vitamin D if they want to have an earlier faster, better, result.

In recent years, vitamin D deficiency has been recognized as a common phenomenon and is caused by many factors. Although it is difficult to get from foods, cod liver oil and other fish such as Halibut supply bountiful amounts. Until recently, the recommended daily allowance was set too low so foods were not supplemented with adequate doses. While people can absorb vitamin D from sunlight, most people often work long hours and use sunscreen that impedes vitamin D intake.

The study was funded, in part, by the Charles Cohn Foundation of Rockville Centre, N.Y.

Hospital of Special Surgery “Hypovitaminosis D in Patients Scheduled to Undergo Orthopaedic Surgery: A Single-Center Analysis.” The Journal of Bone and Joint Surgery, 2010; 92 (13):