Rajani A M, Mittal Ars, Kulkarni V U, Rajani K A, Rajani K A
Department of Orthopaedics, Orthopaedic Arthroscopy Knee and Shoulder Clinic, Mumbai, India.
Department of Clinical Research, Orthopaedic Arthroscopy Knee and Shoulder Clinic, Mumbai, India.
Malays Orthop J. 2024 Nov;18(3):7-15. doi: 10.5704/MOJ.2411.002.
Hypovitaminosis D plays an important role in post-operative bone pain and muscle strength in arthroplasty surgeries. Its role in unicompartmental knee arthroplasty (UKA) has not been elucidated yet. The objective of this study was to determine the impact of hypovitaminosis D and its correction on post-operative bone pain after UKA.
A prospective cohort study involving 240 patients undergoing mobile-bearing medial UKA was conducted. Group A (na=80) received postoperative correction of Vitamin D3 Deficiency (VDD), Group B (nb=80) received pre-operative correction of VDD, while Group C (nc=80) had normal Vitamin D3 levels to begin with (≥30ng/ml). Correction was done by three doses of intramuscular injection of 600,000 IU Arachitol® (Vitamin D3) given at an interval of one week each. All groups were matched for demography and outcome measures. The level of bone pain by checking for tibial shin tenderness quantified by the visual analog scale (VAS) and evaluated pre-operatively, and at 2, 4, 6 and 12 weeks post-operatively.
Group B and C showed similar post-operative trends and remained significantly superior to Group A till the 6th-week follow-up. The biostatistical difference between Group A and the other two groups started decreasing after the completion of post-operative correction regime as noticed on the 6th-week follow-up. By 12 weeks post-operatively, all three groups had similar levels of bone pain.
Vitamin D3 serves as an important preoperative investigation in patients undergoing UKA as it is a modifiable risk factor affecting post-operative bone pain. Its correction pre-operatively gives excellent post-operative pain control.
维生素D缺乏在关节置换手术的术后骨痛和肌肉力量方面起着重要作用。其在单髁膝关节置换术（UKA）中的作用尚未阐明。本研究的目的是确定维生素D缺乏及其纠正对UKA术后骨痛的影响。
对240例行活动平台内侧UKA的患者进行了一项前瞻性队列研究。A组（na = 80）术后纠正维生素D3缺乏（VDD），B组（nb = 80）术前纠正VDD，而C组（nc = 80）初始维生素D3水平正常（≥30ng/ml）。通过每隔一周肌肉注射三剂600,000 IU维生素D3（阿法骨化醇）进行纠正。所有组在人口统计学和结局指标方面进行了匹配。通过视觉模拟量表（VAS）检查胫骨压痛来量化骨痛水平，并在术前以及术后2、4、6和12周进行评估。
B组和C组术后呈现相似趋势，直到术后第6周随访时仍显著优于A组。如在第6周随访时所观察到的，术后纠正方案完成后，A组与其他两组之间的生物统计学差异开始减小。术后12周时，所有三组的骨痛水平相似。
维生素D3是UKA患者重要的术前检查项目，因为它是影响术后骨痛的一个可改变的风险因素。术前对其进行纠正可实现出色的术后疼痛控制。
