Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Warren Alpert Medical School of Brown University, Department of Orthopaedic Surgery, Providence, Rhode Island.
Sports Health. 2024 May-Jun;16(3):465-472. doi: 10.1177/19417381231172726. Epub 2023 May 19.
Vitamin D has been proven experimentally to affect musculoskeletal health. The purpose of this study was to identify the relationship between vitamin D deficiency and patellar instability.
Vitamin D deficiency is associated with an increased risk of experiencing primary patellar instability and recurrent patellar dislocation after primary surgical stabilization.
Retrospective comparative study.
Level 3.
A 1:1 matched retrospective study of 328,011 patients diagnosed with vitamin D deficiency was performed using the PearlDiver database. Incidence of primary patellar instability was calculated according to sex and age. Rates of primary patellar instability and surgical stabilization for recurrent dislocation were calculated with sex- and age-specific stratifications. Multivariable logistic regression was used to compare the rates of primary injury and recurrent stabilization while controlling for demographics and medical comorbidities.
A total of 656,022 patients were analyzed. The overall 1-year incidence rate of patellar instability in patients with vitamin D deficiency was 82.6 per 100,000 person-years (95% CI, 73.2-92.9), compared with 48.5 (95% CI, 41.4-56.5) in the matched control. Women were significantly more likely to experience primary patellar instability within 1 (adjusted odds ratio [aOR] = 1.45; 95% CI, 1.12-1.88) and 2 years (aOR, 1.31; 95% CI, 1.07-1.59) of hypovitaminosis D diagnosis. Patients aged 10 to 25 years with hypovitaminosis D were at greater risk of requiring recurrent patellar stabilization for both men (aOR, 2.48; 95% CI, 1.06-5.80) and women (aOR, 1.77; 95% CI, 1.04-3.02).
Patients diagnosed with vitamin D deficiency experienced higher rates of primary patellar instability and have greater risk of requiring recurrent surgical stabilization for subsequent dislocations.
These results suggest that monitoring and proactively treating vitamin D deficiency in the physically active patient may lower the risk of suffering primary patellar instability or recurrence after surgical stabilization.
维生素 D 已被实验证明会影响肌肉骨骼健康。本研究的目的是确定维生素 D 缺乏与髌骨不稳定之间的关系。
维生素 D 缺乏与经历初次手术稳定后的原发性髌骨不稳定和复发性髌骨脱位的风险增加有关。
回顾性比较研究。
3 级。
使用 PearlDiver 数据库对 328011 例被诊断为维生素 D 缺乏的患者进行了 1:1 匹配的回顾性研究。根据性别和年龄计算原发性髌骨不稳定的发生率。对性别和年龄进行分层，计算原发性髌骨不稳定和复发性脱位的手术稳定率。多变量逻辑回归用于比较初次损伤和复发性稳定的比率，同时控制人口统计学和合并症。
共分析了 656022 例患者。维生素 D 缺乏症患者的总体 1 年髌骨不稳定发生率为 82.6/100000 人年（95%CI，73.2-92.9），而匹配对照组为 48.5/100000 人年（95%CI，41.4-56.5）。女性在诊断为维生素 D 缺乏症后 1 年（调整优势比[aOR] = 1.45；95%CI，1.12-1.88）和 2 年（aOR，1.31；95%CI，1.07-1.59）内更有可能经历原发性髌骨不稳定。10 至 25 岁的维生素 D 缺乏症患者，男性（aOR，2.48；95%CI，1.06-5.80）和女性（aOR，1.77；95%CI，1.04-3.02）复发性髌骨稳定的风险更高。
诊断为维生素 D 缺乏症的患者发生原发性髌骨不稳定的比率较高，且随后脱位后再次接受手术稳定的风险更大。
这些结果表明，在积极活动的患者中监测和积极治疗维生素 D 缺乏症可能会降低原发性髌骨不稳定或手术后复发的风险。
