Many Orthopedic Surgery Patients Low on Vitamin D

Levels should be brought up to normal before operation, researchers say

Bloomberg Businessweek—New York City—October 8, 2010

Nearly half of patients undergoing orthopedic surgery have vitamin D deficiency, which can impair their recovery, researchers say.

In these cases, patients' vitamin D levels need to be brought up to normal levels before they undergo surgery, according to researchers at Hospital for Special Surgery in New York City. Vitamin D is essential for bone healing and muscle function.

"In the perfect world, test levels, fix and then operate," study leader Dr. Joseph Lane, a professor of orthopedic surgery and chief of the hospital's Metabolic Bone Disease Service, said in a hospital news release.

According to Lane, an important part of the healing process -- bone tissue formation -- occurs around two to four weeks after surgery and is the critical period that the body needs vitamin D.

"If you put people on 2,000 to 4,000 [milligrams] of vitamin D based on what their deficient value was, you can usually get them corrected in four to six weeks, which is when you are really going to need the vitamin D," said Lane. "If you are really aggressive right before surgery, you can correct deficient levels quickly, but you have to correct it, measure it, and then act on it."

For this study, Lane and colleagues retrospectively reviewed the medical records of 723 patients who had orthopedic surgery between January 2007 and March 2008 at the Hospital for Special Surgery. The investigators found that 43 percent of the patients had had vitamin D insufficiency (20 nanograms per milliliter [ng/mL] to less than 32 ng/mL) and 40 percent had had vitamin D deficiency (less than 20 ng/mL).

Low vitamin D levels were most common in younger patients, men, and blacks and Hispanics.

"The take-home message is that low vitamin D has an implication in terms of muscle and fracture healing, it occurs in about 50 percent of people coming in for orthopedic surgery, and it is eminently correctable," Lane said.

The study appears in the October issue of the Journal of Bone and Joint Surgery.

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