Men and women who experienced failure of prior total joint replacements were found to have a high incidence of vitamin D deficiency in a study involving 249 patients scheduled for revision arthroplasty (joint replacement revision surgery).¹

Vitamin D, as well as calcium, magnesium and other nutrients, are essential for maintaining healthy bones. The authors of the study noted that vitamin D deficiency is associated with infection around joint prostheses, which is one of the causes of a need for joint replacement revision surgery. They also remarked that impaired bone biology may contribute to loosening of the prosthesis without infection, another cause of joint replacement failure.

Vitamin D use was reported by 23% of the patients. Nineteen percent of the patients who did not use vitamin D had sufficient levels of the vitamin and 81% had insufficient levels (including 53% who had deficient levels). In contrast, among those that reported using vitamin D, 74% were sufficient and 25% had insufficiency.

“We identified an alarming rate of vitamin D deficiency in patients scheduled to undergo revision total joint arthroplasty,” authors Konstantin Horas of the University of Wuerzburg and colleagues concluded. “We recommend that vitamin D levels should generally be assessed in these oftentimes frail and vulnerable patients.”

The study included 116 knee replacement revision patients, 118 patients scheduled to undergo hip replacement revision and 15 that were scheduled for revision of shoulder replacement. Eighty-four patients had infections around their joint prostheses, five had fractures in the surrounding area and 160 had loosening of the implant or other complications.

The researchers involved in the study used vitamin D guidelines established by the US Endocrine Society that categorized 25-hydroxyvitamin D levels of 30 nanograms per milliliter (ng/mL) or more as sufficient, levels of 20–29 ng/mL as insufficient and levels below 20 ng/mL as deficient. Blood samples collected prior to the surgery revealed that patients who did not routinely use vitamin D had average vitamin D levels of 19.91 ng/mL, while those who used the vitamin had levels that averaged 40.66 ng/mL. The findings were reported September 11, 2024, in the journal Nutrients.