Smith J Michael, Cancienne Jourdan M, Brockmeier Stephen F, Werner Brian C
Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, USA.
Midwest Orthopaedics at Rush, Chicago, USA.
Shoulder Elbow. 2021 Feb;13(1):99-105. doi: 10.1177/1758573220906520. Epub 2020 Mar 29.
The primary objective of this study was to examine the relationship between vitamin D deficiency and implant-related and medical complications following total shoulder arthroplasty.
Using the PearlDiver database, patients who underwent total shoulder arthroplasty from 2005 to 2016 with vitamin D deficiency were identified. These were compared to a 3:1 control group matched by age, sex, and presence of a concomitant osteoporosis diagnosis. Primary outcome measures were implant-related complications (loosening, periprosthetic fracture, periprosthetic joint infection, and revision total shoulder arthroplasty) in addition to medical complications within 90 days of surgery. A multivariable logistic regression analysis was utilized to control for patient demographics and comorbidities.
One thousand and six hundred and seventy-four patients with vitamin D deficiency were identified and compared to 5022 controls. There was a significantly higher rate of revision total shoulder arthroplasty in the vitamin D deficient patients compared to controls (2.3% versus 0.8%, odds ratio 3.3, p < 0.0001). After controlling for confounding variables, there were no significant differences in any of the remaining implant-related or medical complications with the exception of higher rates of urinary tract infections in patients with vitamin D deficiency.
Vitamin D deficiency is associated with a higher rate of all-cause revision total shoulder arthroplasty but not medical complications compared to controls. Level III case control study.
本研究的主要目的是探讨维生素D缺乏与全肩关节置换术后植入物相关及医疗并发症之间的关系。
利用PearlDiver数据库，确定2005年至2016年接受全肩关节置换术且存在维生素D缺乏的患者。将这些患者与按年龄、性别和是否伴有骨质疏松症诊断匹配的3:1对照组进行比较。主要结局指标包括植入物相关并发症（松动、假体周围骨折、假体周围关节感染和翻修全肩关节置换术）以及术后90天内的医疗并发症。采用多变量逻辑回归分析来控制患者人口统计学和合并症。
确定了1674例维生素D缺乏患者，并与5022例对照进行比较。与对照组相比，维生素D缺乏患者的翻修全肩关节置换术发生率显著更高（2.3%对0.8%，优势比3.3，p<0.0001）。在控制混杂变量后，除维生素D缺乏患者的尿路感染发生率较高外，其余植入物相关或医疗并发症均无显著差异。
与对照组相比，维生素D缺乏与全因翻修全肩关节置换术的发生率较高相关，但与医疗并发症无关。三级病例对照研究。
