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Is there an association between periprosthetic joint infection and low vitamin D levels?

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Abstract

Purpose

Vitamin D is increasingly being recognized as an important mediator of immune function and may have a preventive role in the pathogenesis of periprosthetic joint infection. To the best of our knowledge, no other study has examined possible associations between periprosthetic joint infection and vitamin D deficiency. We investigated the rate of vitamin D deficiency in patients treated for periprosthetic joint infection and whether vitamin D deficiency is independent of other risk factors for vitamin D deficiency in patients with periprosthetic joint infection.

Methods

Serum 25-hydroxyvitamin D (25OHD) levels of every patient scheduled to receive a total prosthesis either of the hip, knee, or shoulder in the orthopaedic department of the Johannes-Guttenberg-University Hospital in Mainz, Germany (109 patients), were measured after admission. Furthermore, serum 25OHD levels were measured for every patient presenting with periprosthetic joint infection (n = 50) or aseptic loosening of the prosthesis (n = 31) scheduled to undergo revision surgery. The prevalence of normal (>30 ng/ml), insufficient (20–30 ng/ml), and deficient (<20 ng/ml) 25OHD levels was determined.

Results

All tested patient subgroups showed low vitamin D levels. Statistical analysis found no significant difference in vitamin D levels comparing patients with prosthesis and patients with aseptic prosthesis loosening (p = 0.58). Significant differences in 25OHD levels were found comparing patients with periprosthetic joint infection and patients scheduled for primary arthroplasty (p < 0.001). In addition, we found a significant difference (p < 0,001) in 25OHD levels of patients with periprosthetic joint infection compared with patients with aseptic prosthesis loosening.

Conclusion

We found a high frequency of vitamin D deficiency in patients being treated by primary arthroplasty and those with aseptic joint prosthetic loosening and periprosthetic joint infection. Vitamin D deficiency was severe in patients with periprosthetic joint infection.

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Authors and Affiliations

  1. Department of Trauma Surgery, Justus-Liebig-University, Giessen, Germany

    Gerrit Steffen Maier & Jörn Bengt Seeger

  2. Department of Orthopaedic Surgery, Johannes-Gutenberg-University, Mainz, Germany

    Gerrit Steffen Maier, Klaus Edgar Roth & Andreas Alois Kurth

  3. ANZAC Research Institute, University of Sydney, Darlington, Australia

    Konstantin Horas

  4. University Hospital of Orthopaedic Surgery, Pius-Hospital, Oldenburg, Germany

    Uwe Maus

  5. Klinik und Poliklinik für Unfallchirurgie, Universitätsklinikum Gießen, Rudolf-Buchheim-Str. 7, 35932, Gießen, Germany

    Gerrit Steffen Maier

Authors
  1. Gerrit Steffen Maier
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  2. Konstantin Horas
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  3. Jörn Bengt Seeger
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  4. Klaus Edgar Roth
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  5. Andreas Alois Kurth
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  6. Uwe Maus
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Correspondence to Gerrit Steffen Maier.

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Maier, G.S., Horas, K., Seeger, J.B. et al. Is there an association between periprosthetic joint infection and low vitamin D levels?. International Orthopaedics (SICOT) 38, 1499–1504 (2014). https://doi.org/10.1007/s00264-014-2338-6

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  • DOI: https://doi.org/10.1007/s00264-014-2338-6

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