Vitamin D in Orthopädie und Unfallchirurgie

G. S. Maier; U. Maus; D. Lazovic; J. B. Seeger; K. E. Roth; A. A. Kurth; K. Horas

doi:10.1055/s-0038-1673533

Osteologie, Table of Contents

Osteologie 2018; 27(03): 123-128
DOI: 10.1055/s-0038-1673533

Orthopädische Osteologie – Orthopedic Osteology

Georg Thieme Verlag KG Stuttgart · New York

Vitamin D in Orthopädie und Unfallchirurgie

Vitamin D in Orthopaedics and Trauma Surgery

G. S. Maier

¹Universitätsklinik für Orthopädie und Unfallchirurgie, Pius-Hospital, Carl-von-Ossietzky-University, Oldenburg, Germany

,

U. Maus

¹Universitätsklinik für Orthopädie und Unfallchirurgie, Pius-Hospital, Carl-von-Ossietzky-University, Oldenburg, Germany

,

D. Lazovic

¹Universitätsklinik für Orthopädie und Unfallchirurgie, Pius-Hospital, Carl-von-Ossietzky-University, Oldenburg, Germany

,

J. B. Seeger

²Park Klinik, Bad Nauheim, Germany

,

K. E. Roth

³Zentrum für Orthopädie und Unfallchirurgie, Unimedizin Mainz, Mainz, Germany

,

A. A. Kurth

⁴Klinik für Orthopädie und Unfallchirurgie, Kemperhof Koblenz, Gemeinschaftsklinikum Mittelrhein

,

K. Horas

⁵BG Unfallklinik Frankfurt Germany

› Author Affiliations

Abstract

Zusammenfassung

Der Einfluss von Vitamin D im Rahmen der Pathogenese von muskuloskeletalen Erkrankungen ist aktuell ein Thema von hohem wissenschaftlichem Interesse. Nahezu alle Altersschichten der Bevölkerung sind von einer Vitamin-D-Unterversorgung gefährdet. Vitamin D ist ein essenzieller Faktor für die Knochengesundheit und Muskelfunktion, beides Kernelemente der Orthopädie. Zahlreiche Studien zeigten einen möglichen Zusammenhang zwischen dem Serum Vitamin-D-Spiegel und orthopädisch/traumatologischen Krankheitsbildern. In diesen Beobachtungsstudien wurden diverse negative Auswirkungen eines Vitamin-D-Mangels auf das Ergebnis nach Endoprothesenoperationen und den Verlauf orthopädisch/traumatologischer Krankheitsbilder beschrieben. Die vorliegende Arbeit soll einen Überblick über dieses stetig wachsende Themengebiet bieten.

Summary

Vitamin D is a key element in musculoskeletal development, maintenance and function. Sufficient levels of vitamin D correlate with greater bone mineral density, lower rates of osteoporotic fractures and improved neuromuscular interaction. Several epidemiologic studies have identified an increasing number of orthopaedic patients at risk for insufficient serum vitamin D levels, with a high risk for widespread consequences e.g. in bone healing, risk of fracture, periprosthetic infection or post-arthroplastic outcome.

Schlüsselwörter

Vitamin D - Hypovitaminose D - Vitamin D Defizienz - Orthopädie

Keywords

Vitamin D - Vitamin D deficiency - orthopaedics - arthroplasty

Full Text

References

Literatur
1 Zittermann A, Pilz S. [Vitamin D in Clinic and Practice]. Dtsch Med Wochenschr 2017; 142 (08) 601-616.
2 Holick MF. Bioavailability of vitamin D and its metabolites in black and white adults. N Engl J Med 2013; 369 (21) 2047-2048.
3 Holick MF, DeLuca HF. Vitamin D metabolism. Annu Rev Med 1974; 25: 349-367.
4 Wang TJ. et al. Common genetic determinants of vitamin D insufficiency: a genome-wide association study. Lancet 2010; 376 9736 180-188.
5 Holick MF. Vitamin D deficiency. N Engl J Med 2007; 357 (03) 266-281.
6 Kramer J, Diehl A, Lehnert H. [Epidemiological study on the dimension of vitamin D deficiency in North Germany]. Dtsch Med Wochenschr 2014; 139 (10) 470-475.
7 Hintzpeter B, Mensink GB, Thierfelder W, Muller MJ, Scheidt-Nave C. Vitamin D status and health correlates among German adults. Eur J Clin Nutr 2008; 62 (09) 1079-1089.
8 Schilling S. Epidemic vitamin D deficiency among patients in an elderly care rehabilitation facility. Dtsch Arztebl Int 2012; 109 (03) 33-38.
9 Pilz S, Dobnig H, Tomaschitz A, Kienreich K, Meinitzer A, Friedl C, Wagner D, Piswanger-Solkner C, Marz W, Fahrleitner-Pammer A. Low 25-hydroxyvitamin D is associated with increased mortality in female nursing home residents. J Clin Endocrinol Metab 2012; 97 (04) E653-E657.
10 Maier GS, Jakobs P, Roth KE, Kurth AA, Maus U. Is there an epidemic vitamin D deficiency in German orthopaedic patients?. Clin Orthop Relat Res 2013; 471 (09) 3029-3035.
11 Maier GS, Horas K, Seeger JB, Roth KE, Kurth AA, Maus U. Vitamin D insufficiency in the elderly orthopaedic patient: an epidemic phenomenon. Int Orthop 2015; 39 (04) 787-792.
12 Nakamura K, Saito T, Oyama M, Oshiki R, Kobayashi R, Nishiwaki T, Nashimoto M, Tsuchiya Y. Vitamin D sufficiency is associated with low incidence of limb and vertebral fractures in community-dwelling elderly Japanese women: the Muramatsu Study. Osteoporos Int 2011; 22 (01) 97-103.
13 Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R. Estimates of optimal vitamin D status. Osteoporos Int 2005; 16 (07) 713-716.
14 Gerdhem P, Ringsberg KA, Obrant KJ, Akesson K. Association between 25-hydroxy vitamin D levels, physical activity, muscle strength and fractures in the prospective population-based OPRA Study of Elderly Women. Osteoporos Int 2005; 16 (11) 1425-1431.
15 Lopes JB, Danilevicius CF, Takayama L, Caparbo VF, Scazufca M, Bonfa E, Pereira RM. Vitamin D insufficiency: a risk factor to vertebral fractures in community-dwelling elderly women. Maturitas 2009; 64 (04) 218-222.
16 Cummings SR, Browner WS, Bauer D, Stone K, Ensrud K, Jamal S, Ettinger B. Endogenous hormones and the risk of hip and vertebral fractures among older women. Study of Osteoporotic Fractures Research Group. N Engl J Med 1998; 339 (11) 733-738.
17 Maier GS, Seeger JB, Horas K, Roth KE, Kurth AA, Maus U. The prevalence of vitamin D deficiency in patients with vertebral fragility fractures. Bone Joint J 2015; 97-B (01) 89-93.
18 Rommens PM, Hofmann A. Comprehensive classification of fragility fractures of the pelvic ring: Recommendations for surgical treatment. Injury 2013; 44 (12) 1733-1744.
19 Maier GS, Kolbow K, Lazovic D, Horas K, Roth KE, Seeger JB, Maus U. Risk factors for pelvic insufficiency fractures and outcome after conservative therapy. Arch Gerontol Geriatr 2016; 67: 80-85.
20 Dell RM, Greene D, Anderson D, Williams K. Osteoporosis disease management: What every orthopaedic surgeon should know. J Bone Joint Surg Am 2009; 91 Suppl. 6 79-86.
21 de L II, van der Klift M, de Laet CE, van Daele PL, Hofman A, Pols HA. Bone mineral density and fracture risk in type-2 diabetes mellitus: the Rotterdam Study. Osteoporos Int 2005; 16 (12) 1713-1720.
22 Freedman KB, Kaplan FS, Bilker WB, Strom BL, Lowe RA. Treatment of osteoporosis: are physicians missing an opportunity?. J Bone Joint Surg Am 2000; 82-A (08) 1063-1070.
23 Hill RM, Robinson CM, Keating JF. Fractures of the pubic rami. Epidemiology and five-year survival. J Bone Joint Surg Br 2001; 83 (08) 1141-1144.
24 Morris RO, Sonibare A, Green DJ, Masud T. Closed pelvic fractures: characteristics and outcomes in older patients admitted to medical and geriatric wards. Postgrad Med J 2000; 76 (900) 646-650.
25 Hewison M. Vitamin D and the immune system: new perspectives on an old theme. Endocrinol Metab Clin North Am 2010; 39 (02) 365-379.
26 Maier GS, Horas K, Seeger JB, Roth KE, Kurth AA, Maus U. Is there an association between periprosthetic joint infection and low vitamin D levels?. Int Orthop 2014; 38 (07) 1499-1504.
27 Tiwari S, Pratyush DD, Gupta B, Dwivedi A, Chaudhary S, Rayicherla RK, Gupta SK, Singh SK. Prevalence and severity of vitamin D deficiency in patients with diabetic foot infection. Br J Nutr 2013; 109 (01) 99-102.
28 Tiwari S, Pratyush DD, Gupta SK, Singh SK. Vitamin D deficiency is associated with inflammatory cytokine concentrations in patients with diabetic foot infection. Br J Nutr 2014; 112 (12) 1938-1943.
29 van Etten E, Decallonne B, Bouillon R, Mathieu C. NOD bone marrow-derived dendritic cells are modulated by analogs of 1,25-dihydroxyvitamin D3. J Steroid Biochem Mol Biol 2004; 89–90 1–5 457-459.
30 van Etten E, Mathieu C. Immunoregulation by 1,25-dihydroxyvitamin D3: basic concepts. J Steroid Biochem Mol Biol 2005; 97 1–2 93-101.
31 Youssef DA, Miller CW, El-Abbassi AM, Cutchins DC, Cutchins C, Grant WB, Peiris AN. Antimicrobial implications of vitamin D. Dermatoendocrinol 2011; 03 (04) 220-229.
32 Feindt E, Stroder J. [Studies on the antimicrobial effect of vitamin D (author’s transl)]. Klin Wochenschr 1977; 55 (10) 507-508.
33 Cannell JJ, Hollis BW. Use of vitamin D in clinical practice. Altern Med Rev 2008; 13 (01) 6-20.
34 Liu PT, Stenger S, Tang DH, Modlin RL. Cutting edge: vitamin D-mediated human antimicrobial activity against Mycobacterium tuberculosis is dependent on the induction of cathelicidin. J Immunol 2007; 179 (04) 2060-2063.
35 Bruns J, Werner M, Soyka M. Is vitamin D insufficiency or deficiency related to the development of osteochondritis dissecans?. Knee Surg Sports Traumatol Arthrosc 2016; 24 (05) 1575-1579.
36 Maier GS, Lazovic D, Maus U, Roth KE, Horas K, Seeger JB. Vitamin D Deficiency: The Missing Etiological Factor in the Development of Juvenile Osteochondrosis Dissecans?. J Pediatr Orthop. 2016 doi:10.1097/BPO.0000000000000921.
37 Quan AW, Beall DP, Berry ER, Ly JQ, Sweet CF, Fish JR. A case of osteochondritis dissecans in rickets. Emerg Radiol 2005; 11 (04) 219-221.
38 Krause M, Lehmann D, Amling M, Rolvien T, Frosch KH, Puschel K, Bohndorf K, Meenen NM. Intact bone vitality and increased accumulation of nonmineralized bone matrix in biopsy specimens of juvenile osteochondritis dissecans: a histological analysis. Am J Sports Med 2015; 43 (06) 1337-1347.
39 Jansen JA, Haddad FS. High prevalence of vitamin D deficiency in elderly patients with advanced osteoarthritis scheduled for total knee replacement associated with poorer preoperative functional state. Ann R Coll Surg Engl 2013; 95 (08) 569-572.
40 Sanghi D, Mishra A, Sharma AC, Singh A, Natu SM, Agarwal S, Srivastava RN. Does vitamin D improve osteoarthritis of the knee: a randomized controlled pilot trial. Clin Orthop Relat Res 2013; 471 (11) 3556-3562.
41 Laslett LL, Quinn S, Burgess JR, Parameswaran V, Winzenberg TM, Jones G, Ding C. Moderate vitamin D deficiency is associated with changes in knee and hip pain in older adults: a 5-year longitudinal study. Ann Rheum Dis 2014; 73 (04) 697-703.
42 Nawabi DH, Chin KF, Keen RW, Haddad FS. Vitamin D deficiency in patients with osteoarthritis undergoing total hip replacement: a cause for concern?. J Bone Joint Surg Br 2010; 92 (04) 496-499.
43 Cao Y, Winzenberg T, Nguo K, Lin J, Jones G, Ding C. Association between serum levels of 25-hydroxyvitamin D and osteoarthritis: a systematic review. Rheumatology (Oxford) 2013; 52 (07) 1323-1334.
44 Unnanuntana A, Saleh A, Nguyen JT, Sculco TP, Cornell CN, Mancuso CA, Lane JM. Low vitamin D status does not adversely affect short-term functional outcome after total hip arthroplasty. J Arthroplasty 2013; 28 (02) 315-322.
45 Waldron JL, Ashby HL, Cornes MP, Bechervaise J, Razavi C, Thomas OL, Chugh S, Deshpande S, Ford C, Gama R. Vitamin D: a negative acute phase reactant. J Clin Pathol 2013; 66 (07) 620-622.
46 LeBoff MS, Hawkes WG, Glowacki J, Yu-Yahiro J, Hurwitz S, Magaziner J. Vitamin D-deficiency and post-fracture changes in lower extremity function and falls in women with hip fractures. Osteoporos Int 2008; 19 (09) 1283-1290.
47 Matthews LR, Ahmed Y, Wilson KL, Griggs DD, Danner OK. Worsening severity of vitamin D deficiency is associated with increased length of stay, surgical intensive care unit cost, and mortality rate in surgical intensive care unit patients. Am J Surg 2012; 204 (01) 37-43.
48 Helard L, Mateus-Hamdan L, Beauchet O, Annweiler C. Hypovitaminosis D in geriatric acute care unit: a biomarker of longer length of stay. Dis Markers 2013; 35 (05) 525-529.
49 Maier GS, Maus U, Lazovic D, Horas K, Roth KE, Kurth AA. Is there an association between low serum 25-OH-D levels and the length of hospital stay in orthopaedic patients after arthroplasty?. J Orthop Traumatol 2016; 17 (04) 297-302.
50 Lee A, Chan SK, Samy W, Chiu CH, Gin T. Effect of Hypovitaminosis D on Postoperative Pain Outcomes and Short-Term Health-Related Quality of Life After Knee Arthroplasty: A Cohort Study. Medicine (Baltimore) 2015; 94 (42) e1812.
51 Amling M. [Calcium and vitamin D in bone metabolism: Clinical importance for fracture treatment]. Unfallchirurg 2015; 118 (12) 995-999.
52 Amling M, Priemel M, Holzmann T, Chapin K, Rueger JM, Baron R, Demay MB. Rescue of the skeletal phenotype of vitamin D receptor-ablated mice in the setting of normal mineral ion homeostasis: formal histomorphometric and biomechanical analyses. Endocrinology 1999; 140 (11) 4982-4987.
53 Li YC, Pirro AE, Amling M, Delling G, Baron R, Bronson R, Demay MB. Targeted ablation of the vitamin D receptor: an animal model of vitamin D-dependent rickets type II with alopecia. Proc Natl Acad Sci U S A 1997; 94 (18) 9831-9835.
54 Gorter EA, Hamdy NA, Appelman-Dijkstra NM, Schipper IB. The role of vitamin D in human fracture healing: a systematic review of the literature. Bone 2014; 64: 288-297.
55 Brinker MR, O’Connor DP, Monla YT, Earthman TP. Metabolic and endocrine abnormalities in patients with nonunions. J Orthop Trauma 2007; 21 (08) 557-570.
56 Tauber C, Noff D, Noff M, Malkin C. Blood levels of active metabolites of vitamin D3 in fracture repair in humans. A preliminary report. Arch Orthop Trauma Surg 1990; 109 (05) 265-267.
57 Boszczyk AM, Zakrzewski P, Pomianowski S. Vitamin D concentration in patients with normal and impaired bone union. Pol Orthop Traumatol 2013; 78: 1-3.
58 Haining SA, Atkins RM, Guilland-Cumming DF, Sharrard WJ, Russell RG, Kanis JA. Vitamin D metabolites in patients with established non-union of fracture. Bone Miner 1986; 01 (03) 205-209.