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Review
. 2020 Mar 25:21:109-116.
doi: 10.1016/j.jor.2020.03.010. eCollection 2020 Sep-Oct.

Hypovitaminosis D in lower extremity Joint Arthroplasty: A systematic review and meta-analysis

Ahmed K Emara  1 , Emmanuel Nageeb  1 , Jaiben George  1 , Martin A Buttaro  2 , Carlos Higuera  1 , Nicolas S Piuzzi  1   3
Affiliations
Review

Hypovitaminosis D in lower extremity Joint Arthroplasty: A systematic review and meta-analysis

Ahmed K Emara et al. J Orthop. .

Abstract

The purpose of the current systematic review was to identify the prevalence of hypovitaminosis-D in LE-TJA patients; and outline the association between pre-operative hypovitaminosis and post-operative outcomes. A search of PubMed-Medline and the Cochrane-Library databases was performed for literature published before November 27th, 2019. The eighteen studies analyzed had a pooled prevalence for vitamin D insufficiency (20 - <30 ng/mL) and deficiency (<20 ng/mL) of 53.4% and 39.4%, respectively. Hypovitaminosis-D was associated with higher complication rates (p = 0.043), and a greater prevalence among septic versus aseptic revisions (p = 0.016). Therefore, pre-operative screening for hypovitaminosis-D can be beneficial in patients undergoing LE-TJA.

Level of evidence: Systematic Review (Level III).

Keywords: Hypovitaminosis-D; Total hip arthroplasty; Total knee arthroplasty; Vitamin-D; Vitamin-D deficiency.

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Conflict of interest statement

•Carlos Higuera has the following disclosures to declare, all of which being unrelated to the topic of this study: Research Support: CD Diagnostics, Cymedica, Ferring Pharmaceuticals, Orthofix, Inc, Orthogenics, Stryker, Zimmer, OREF, and KCI. Editorial or governing board: American Journal of Orthopedics, Journal of Arthroplasty, Journal of Hip Surgery, Journal of Knee Surgery. Paid consultant/presenter: KCI. Stock or Stock Options: PSI.•Nicolas S. Piuzzi has the following disclosures to declare, all of which being unrelated to the topic of this study: ISCT: Board or committee member; Orthopaedic Research Society: Board or committee member; Zimmer: Research support.•Ahmed K. Emara, Emmanuel Nageeb, Jaiben George, Martin A. Buttaro, and Nicolas S. Piuzzi declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flow Diagram (PRISMA Chart) Presenting the Systematic Review Process Used in this Study.
Fig. 2
Fig. 2
Forest Plot showing the Pooled Prevalence of Vitamin D Insufficiency.
Fig. 3
Fig. 3
Forest plot showing the pooled prevalence of vitamin d deficiency.
Fig. 4
Fig. 4
Forest plot of total WOMAC scores in vitamin d deficient versus sufficient groups.
See this image and copyright information in PMC

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