Vitamin D Status and Patient Outcomes after Knee or Hip Surgery: A Meta-Analysis

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Abstract

Background: This study evaluates the effect of vitamin D status in patient outcomes after hip or knee joint surgery. Method: Literature search was carried out in electronic databases, and study selection followed predetermined eligibility criteria. Data were extracted from relevant studies and meta-analyses of standardized mean differences between hypovitaminosis D (vitamin D deficiency or insufficiency) and euvitaminosis D in assessment scores of patient-reported outcomes were performed. Results: A total of 12 studies (2,593 patients; age 69.89 years [95% CI 68.07–71.70]; 35.95% [29.43–42.46] males) were included in the meta-analysis. The prevalence of hypovitaminosis D (vitamin D deficiency or insufficiency) was 33.18% [25.10–41.26], but the combined prevalence of deficiency and insufficiency was 46.99 [34.02–59.96]. Hospital stay was 1.09 days [–0.39 to 2.56] longer in the hypovitaminosis D group compared to the euvitaminosis D group. Preoperatively, Harris Hip Score (HHS) and Knee Society Score were significantly lower (p = 0.001 and p = 0.00001, respectively) in the hypovitaminosis D group than in the euvitaminosis D group. Postoperatively, HHS (p = 0.004) score was significantly lower in the hypovitaminosis D group than in the euvitaminosis D group. Conclusion: The prevalence of hypovitaminosis D is high in osteoarthritis patients undergoing knee or hip surgery. Vitamin D deficiency may affect the outcomes of orthopedic joint surgery. However, randomized trial/s will be required to confirm these findings.

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