Vitamin D deficiency may lead to poor outcomes, pain in postmenopausal women after TKA
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According to published results, preoperative vitamin D deficiency may adversely affect early functional outcomes and increase the risk of moderate to severe knee pain in postmenopausal women who undergo total knee arthroplasty.
To study the effect of preoperative serum 25-hydroxyvitamin D levels on clinical outcomes after TKA, Yu Song, MD, and colleagues retrospectively analyzed the results of 226 postmenopausal women who underwent TKA for osteoarthritis-related symptoms from April 2017 to December 2019. The women were separated into two cohorts: a vitamin D-sufficient group (30 ng/mL) and a vitamin D-deficient group (<30 ng/mL).
Outcome measures included the VAS, WOMAC and Knee Society Score (KSS). According to the study, the researchers also performed multivariate logistic regression analysis to determine the impact of vitamin D deficiency, smoking and high BMI on outcomes in the cohort.
Song and colleagues found no significant differences in postoperative VAS and KSS; however, they found a “statistically significant” difference in postoperative WOMAC scores between the women who were vitamin D sufficient (15.3) and vitamin D deficient (15.6). In addition, Song and colleagues noted vitamin D deficiency, smoking and high BMI were independent risk factors for postoperative moderate to severe knee pain.
“Estrogen deficiency in perimenopausal women is associated with decreased levels of vitamin D. In addition, low dietary intake of vitamin D, impaired skin synthesis of vitamin D, a sedentary lifestyle that reduces sunlight exposures and decreased hydroxylation of the liver and kidneys also contribute to vitamin D deficiency in perimenopausal women,” the researchers wrote in the study. “Clinicians must, therefore, carefully screen preoperative vitamin D levels in postmenopausal women scheduled for TKA to identify high-risk women before surgery and improve prognosis,” they concluded.
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