Departamento de Ortopedia y Traumatología Infantil - Sanatorio Allende, Córdoba, Argentina.
Departamento de Ortopedia y Traumatología Infantil - Sanatorio Allende, Córdoba, Argentina.
Rev Esp Cir Ortop Traumatol (Engl Ed). 2021 Mar-Apr;65(2):132-137. doi: 10.1016/j.recot.2020.07.006. Epub 2020 Dec 4.
Juvenile osteochondritis dissecans (JOCD) is an acquired joint disease of unknown etiology that affects skeletally immature patients and has the potential to progress to osteoarthritis. Recent studies have reported a high prevalence of vitaminD deficiency in patients with osteochondral lesions. The aim of our study was to determine serum vitaminD levels in patients diagnosed with JOCD.
Serum 25(OH)D levels of 31 patients (22 males) presenting 40 lesions (29 JOCD of the knee, and 11 of the ankle) were evaluated. The average age was 11.9±2.9years. HypovitaminosisD was defined as a value less than 30ng/mL and was divided into vitaminD insufficiency (20 to 30ng/mL) and vitaminD deficiency (<20ng/mL).
HypovitaminosisD was present in 45.2% of the evaluated patients (32.2% insufficiency and 13% deficiency). No significant differences were found in the mean values and incidence of hypovitaminosis between those patients in which the sample was taken in warm or cold season (P=.267 and P=.875, respectively). Patients who required surgery had a higher incidence of hypovitaminosis than those treated conservatively (60% versus 31%, P=.054). There was no correlation in the incidence of hypovitaminosis with sex, location, stability of the lesion, or if the lesion was uni- or bilateral.
In our series, almost half of the patients diagnosed with JOCD presented abnormal serum levels of vitaminD. A two-fold incidence of hypovitaminosis was observed in patients requiring surgical treatment compared to patients managed conservatively. The association found in this study does not imply causation, but it should be considered within the set of actions for the treatment of these injuries.
青少年剥脱性骨软骨炎（JOCD）是一种病因不明的获得性关节疾病，影响骨骼未成熟的患者，并有发展为骨关节炎的潜力。最近的研究报告称，患有骨软骨病变的患者中维生素 D 缺乏症的患病率很高。我们的研究目的是确定诊断为 JOCD 的患者的血清维生素 D 水平。
评估了 31 名患者（22 名男性）的 40 处病变（29 处膝关节 JOCD，11 处踝关节 JOCD）的血清 25（OH）D 水平。平均年龄为 11.9±2.9 岁。维生素 D 缺乏症定义为值小于 30ng/mL，并分为维生素 D 不足（20 至 30ng/mL）和维生素 D 缺乏症（<20ng/mL）。
45.2%的患者存在维生素 D 缺乏症（32.2%为不足，13%为缺乏）。在温暖季节或寒冷季节采集样本的患者中，维生素 D 缺乏症的平均水平和发生率没有显著差异（分别为 P=.267 和 P=.875）。需要手术的患者维生素 D 缺乏症的发生率高于保守治疗的患者（60%比 31%，P=.054）。维生素 D 缺乏症的发生率与性别、病变位置、病变稳定性以及病变是单侧还是双侧无关。
在我们的系列中，近一半被诊断为 JOCD 的患者的血清维生素 D 水平异常。与接受保守治疗的患者相比，需要手术治疗的患者维生素 D 缺乏症的发生率增加了一倍。本研究发现的相关性并不意味着因果关系，但在治疗这些损伤时应考虑这一因素。
