Elective Orthopaedic and Trauma Patients in Southern Italy are Vitamin D Deficient. A Pilot Study

Many patients present with Vitamin D (Vit d; 25 (OH) D) deficiency on admission to hospital. The present study evaluated the levels of serum concentration of 25 (OH) D in patients undergoing elective arthroplasty of the hip and knee and in patients with proximal femur fracture. A total of 90 patients of both sex were recruited, 20 with osteoarthritis of the knee, 29 with osteoarthritis of the hip, and 41 with a hip fracture. The levels of Vit D were measured twice: on admission and on the fourth day after surgery. In patients undergoing knee arthroplasty, the levels of Vit D were 16.85 ng/ml in the preoperative and 18.235 ng/ml in the postoperative period. In patients undergoing hip arthroplasty, we found levels <4.20 ng/ml for men, while in women 25.20 ng/ml pre-operatively and 22.8 ng/ml post-operatively. In patients with a hip fracture, men progressed from very low levels preoperatively (6.38 ng/ml) with post-operative levels of 18.44 ng /ml. Women exhibited a slight improvement from 12.24 ng/ml pre-operatively to 17.9 ng/ml postoperatively. Patients who are candidates for hip and knee arthroplasty and in hip fracture patients exhibit low Vit D levels. The activation of the inflammatory cascade may induce reduction of Vit D levels, and this fall is associated with impaired bone health.