Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, 59, Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.
Department of Orthopaedic Surgery, Denver Health Medical Center, Denver, CO, USA.
BMC Musculoskelet Disord. 2020 Apr 17;21(1):251. doi: 10.1186/s12891-020-03295-1.
This study aimed to evaluate the effects of vitamin D deficiency on the functional outcomes following a high tibial osteotomy (HTO).
Clinical data of 209 patients (327 knees) who underwent HTO done by a single surgeon were retrospectively registered for the study. Ninety-four patients (94 knees) who underwent HTO were analyzed. Patients were assigned into two groups according to their preoperative serum vitamin D levels (D- Deficiency and S- Sufficient); < 20 ng/ml (group D, N = 48) and ≥ 20 ng/ml (group S, N = 46) respectively. A subjective form of International Knee Documentation Committee (IKDC) score, mechanical alignment, and cartilage status before and 1 year following HTO were studied between groups.
The mean postoperative IKDC score was significantly higher in group S (p = 0.012). Moreover, the difference of IKDC score between pre- and post- HTO was also significantly higher in group S (p = 0.006). Preoperative vitamin D level and IKDC score did not show a significant correlation. Serum vitamin D level was found to be moderately correlated to postoperative IKDC score (r = 0.342 and, p = 0.001). A moderately positive correlation between serum vitamin D level and improvement of IKDC score following osteotomy was appreciated (r = 0.381 and, p < 0.001).
Patients with vitamin D deficiency had less satisfactory functional outcomes within 1 year from HTO surgery. Our results suggest that preoperative serum vitamin D level is one of the factors affecting the outcome after HTO. We recommended analyzing serum vitamin D levels as part of the routine workup in patients undergoing HTO.
本研究旨在评估维生素 D 缺乏对胫骨高位截骨（HTO）后功能结果的影响。
回顾性登记了一位医生进行的 209 例（327 膝）HTO 患者的临床资料，对其中 94 例（94 膝）患者进行了分析。根据术前血清维生素 D 水平将患者分为两组（D-缺乏和 S-充足）；<20ng/ml（组 D，N=48）和≥20ng/ml（组 S，N=46）。研究了两组患者术前、术后 1 年的国际膝关节文献委员会（IKDC）评分、机械对线和软骨状况。
组 S 的平均术后 IKDC 评分显著较高（p=0.012）。此外，组 S 的 IKDC 评分在术前和术后的差异也显著更高（p=0.006）。术前维生素 D 水平与 IKDC 评分无显著相关性。血清维生素 D 水平与术后 IKDC 评分中度相关（r=0.342，p=0.001）。血清维生素 D 水平与截骨术后 IKDC 评分的改善呈中度正相关（r=0.381，p<0.001）。
维生素 D 缺乏的患者在 HTO 手术后 1 年内功能结果较差。我们的结果表明，术前血清维生素 D 水平是影响 HTO 后结果的因素之一。我们建议在进行 HTO 时分析血清维生素 D 水平作为常规检查的一部分。
