Shin Keun-Young, Park Kwan Kyu, Moon Seong-Hwan, Yang Ick Hwan, Choi Ho-June, Lee Woo-Suk
Department of Orthopaedic Surgery, College of Medicine, Gangnam Severance Hospital, Yonsei University, 211 Eonju-ro, Gangnam-Gu, Seoul, 135-720, Republic of Korea.
Knee Surg Sports Traumatol Arthrosc. 2017 Nov;25(11):3424-3430. doi: 10.1007/s00167-016-4209-8. Epub 2016 Jun 17.
Vitamin D has received considerable attention in recent years owing to the increasing evidence of its importance in muscle function and physical performance. The present study attempted to determine whether patients with low serum vitamin D levels had impairment in early functional outcomes following total knee arthroplasty (TKA).
This was a prospective cohort study that included 92 patients. Patients were divided into two groups according to their vitamin D levels as assessed at the preoperative visit: (1) vitamin D-deficient group, serum 25-hydroxyvitamin D (25(OH)D) levels <12 ng/mL; (2) vitamin D non-deficient group, serum 25(OH)D levels ≥12 ng/mL. American Knee Society Score (KSS) and four other performance tests including the alternative step test (AST), six-metre walk test (SMT), sit-to-stand test (STS), and timed up and go test (TUGT) were used for assessment of post-operative function. All assessments were performed one day before and three months after TKA.
Of the 92 patients included in the study, 87 patients performed all required assessments. The mean post-operative functional KSS was significantly lesser in the vitamin D-deficient group than in the vitamin D non-deficient group (67.2 vs. 73.4, p = 0.031). The mean values of time taken for post-operative AST (16.6 vs. 14.6 s, p = 0.033) and SMT (8.8 vs. 7.7 s, p = 0.012) were significantly longer in the vitamin D-deficient group than in the vitamin D non-deficient group. Post-operative STS and TUGT demonstrated higher values for mean time taken in the vitamin D-deficient group than in the vitamin D non-deficient group, but these were not statistically significant (13.6 vs. 12.4 s, not significant (n.s.); 12.7 vs. 11.7 s, n.s., respectively).
Early post-operative functional outcomes following TKA appear to be adversely affected by vitamin D deficiency.
Prospective cohort study, Level II.
近年来，维生素D因其在肌肉功能和身体表现方面的重要性证据不断增加而受到广泛关注。本研究旨在确定血清维生素D水平低的患者在全膝关节置换术（TKA）后早期功能结局是否受损。
这是一项前瞻性队列研究，纳入92例患者。根据术前访视时评估的维生素D水平将患者分为两组：（1）维生素D缺乏组，血清25-羟基维生素D（25(OH)D）水平＜12 ng/mL；（2）维生素D非缺乏组，血清25(OH)D水平≥12 ng/mL。采用美国膝关节协会评分（KSS）以及包括交替步试验（AST）、六米步行试验（SMT）、坐立试验（STS）和计时起立行走试验（TUGT）在内的其他四项性能测试来评估术后功能。所有评估均在TKA前一天和术后三个月进行。
在纳入研究的92例患者中，87例患者完成了所有所需评估。维生素D缺乏组术后功能性KSS的平均值显著低于维生素D非缺乏组（67.2对73.4，p = 0.031）。维生素D缺乏组术后AST（16.6对14.6秒，p = 0.033）和SMT（8.8对7.7秒，p = 0.012）的平均用时显著长于维生素D非缺乏组。术后STS和TUGT显示维生素D缺乏组的平均用时高于维生素D非缺乏组，但差异无统计学意义（13.6对12.4秒，无显著性差异（n.s.）；12.7对11.7秒，n.s.）。
TKA术后早期功能结局似乎受到维生素D缺乏的不利影响。
前瞻性队列研究，二级。
