Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 25, Issue 11, pp 3424–3430 | Cite as

Vitamin D deficiency adversely affects early post-operative functional outcomes after total knee arthroplasty

  • Keun-Young Shin
  • Kwan Kyu Park
  • Seong-Hwan Moon
  • Ick Hwan Yang
  • Ho-June Choi
  • Woo-Suk LeeEmail author



Vitamin D has received considerable attention in recent years owing to the increasing evidence of its importance in muscle function and physical performance. The present study attempted to determine whether patients with low serum vitamin D levels had impairment in early functional outcomes following total knee arthroplasty (TKA).


This was a prospective cohort study that included 92 patients. Patients were divided into two groups according to their vitamin D levels as assessed at the preoperative visit: (1) vitamin D-deficient group, serum 25-hydroxyvitamin D3 (25(OH)D) levels <12 ng/mL; (2) vitamin D non-deficient group, serum 25(OH)D levels ≥12 ng/mL. American Knee Society Score (KSS) and four other performance tests including the alternative step test (AST), six-metre walk test (SMT), sit-to-stand test (STS), and timed up and go test (TUGT) were used for assessment of post-operative function. All assessments were performed one day before and three months after TKA.


Of the 92 patients included in the study, 87 patients performed all required assessments. The mean post-operative functional KSS was significantly lesser in the vitamin D-deficient group than in the vitamin D non-deficient group (67.2 vs. 73.4, p = 0.031). The mean values of time taken for post-operative AST (16.6 vs. 14.6 s, p = 0.033) and SMT (8.8 vs. 7.7 s, p = 0.012) were significantly longer in the vitamin D-deficient group than in the vitamin D non-deficient group. Post-operative STS and TUGT demonstrated higher values for mean time taken in the vitamin D-deficient group than in the vitamin D non-deficient group, but these were not statistically significant (13.6 vs. 12.4 s, not significant (n.s.); 12.7 vs. 11.7 s, n.s., respectively).


Early post-operative functional outcomes following TKA appear to be adversely affected by vitamin D deficiency.

Level of evidence

Prospective cohort study, Level II.


Total knee arthroplasty Vitamin D Functional outcomes American Knee Society Score Performance tests 



We thank Nam Kyu Um, MD (College of Medicine, Yonsei University, Seoul, Korea) for his assistance in the assessment of outcome parameters. We also thank Jung Hwa Hong for her assistance with statistics.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to declare.


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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2016

Authors and Affiliations

  • Keun-Young Shin
    • 1
  • Kwan Kyu Park
    • 1
  • Seong-Hwan Moon
    • 1
  • Ick Hwan Yang
    • 1
  • Ho-June Choi
    • 1
  • Woo-Suk Lee
    • 1
    Email author
  1. 1.Department of Orthopaedic Surgery, College of MedicineGangnam Severance Hospital, Yonsei UniversityGangnam-GuRepublic of Korea

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