Department of Orthopedics, Koenig-Ludwig-Haus, University of Wuerzburg, Wuerzburg, Germany.
Department of Orthopedic Surgery, Diakonissen Hospital, Schladming, Austria.
Foot Ankle Int. 2019 Nov;40(11):1309-1318. doi: 10.1177/1071100719864325. Epub 2019 Aug 2.
Low vitamin D levels are common in patients with foot and ankle disorders. We have previously demonstrated that juveniles diagnosed with osteochondritis dissecans (OCD) have a high prevalence of vitamin D deficiency. Moreover, there is evidence that OCD might be related to vitamin D deficiency in general. However, whether or not hypovitaminosis D is associated with OCD of the talus has yet to be elucidated.
The aim of this study was to determine serum vitamin D levels [25(OH)D] of patients diagnosed with traumatic and idiopathic OCD of the talus. The vitamin D status of patients was measured and correlated to age, sex, season, etiology, laterality, degree of disease, and nicotine abuse. Moreover, parathyroid hormone and serum calcium levels of patients were obtained to assess for severe vitamin D deficiency and secondary hyperparathyroidism. Between January 2015 and December 2017, 65 patients with a mean age of 38.9 years and a total of 68 lesions were identified.
In total, 75.4% of patients had low vitamin D levels with a mean overall 25(OH)D level of 24.2 ng/mL. Specifically, 35.4% of patients were vitamin D deficient; another 40% were vitamin D insufficient, and only 24.6% of patients presented with sufficient vitamin D levels. Statistical analysis showed no significant difference comparing vitamin D levels of patients with idiopathic OCD to patients with traumatic OCD.
We could not find any significant differences in the vitamin D status of patients with OCD of the talus compared with patients with foot and ankle disorders in general. However, we found that vitamin D deficiency was frequent in patients presenting with traumatic and idiopathic OCD of the talus. We believe it might be beneficial to routinely assess and treat the vitamin D status of patients.
Level III, retrospective comparative study.
足部和踝关节疾病患者的维生素 D 水平普遍较低。我们之前已经证明，被诊断为骺软骨骨软骨病（OCD）的青少年普遍存在维生素 D 缺乏症。此外，有证据表明 OCD 可能与一般的维生素 D 缺乏有关。然而，维生素 D 缺乏症是否与距骨 OCD 有关仍有待阐明。
本研究旨在确定被诊断为创伤性和特发性距骨 OCD 的患者的血清维生素 D 水平[25（OH）D]。测量了患者的维生素 D 状况，并将其与年龄、性别、季节、病因、侧别、疾病程度和尼古丁滥用相关联。此外，还获得了甲状旁腺激素和血清钙水平，以评估严重的维生素 D 缺乏症和继发性甲状旁腺功能亢进症。2015 年 1 月至 2017 年 12 月期间，共发现 65 例平均年龄为 38.9 岁的患者，总计 68 处病灶。
共有 75.4%的患者维生素 D 水平较低，总 25（OH）D 水平平均为 24.2ng/mL。具体而言，35.4%的患者存在维生素 D 缺乏症；40%的患者存在维生素 D 不足，仅有 24.6%的患者具有足够的维生素 D 水平。统计分析显示，特发性 OCD 患者与一般足部和踝关节疾病患者的维生素 D 水平无显著差异。
我们没有发现距骨 OCD 患者的维生素 D 状态与一般足部和踝关节疾病患者有任何显著差异。但是，我们发现创伤性和特发性距骨 OCD 患者中维生素 D 缺乏症很常见。我们认为，常规评估和治疗患者的维生素 D 状态可能会有益。
三级，回顾性比较研究。
