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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
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
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):

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