title: Effect of Preoperative Vitamin D Levels on Functional Performance after Total Knee Arthroplasty.
abstract: BACKGROUND
  Low vitamin D levels affects muscle function. Vitamin D and calcium deficiency cause osteomalacic myopathy and poor functional recovery after hip fractures. The relationship of vitamin D and functional performance after total knee arthroplasty (TKA) is not previously reported.
  
  
  METHODS
  Influence of vitamin D on functional performance before and after TKA was reviewed retrospectively in 120 patients. Of these, 64 had vitamin D deficiency (25-hydroxy vitamin D < 30 ng/mL) preoperatively. All 120 patients received vitamin D oral supplementation postoperatively. Functional parameters including Western Ontario and McMaster Osteoarthritis Index (WOMAC), Short-Form Health Survey questionnaire, and Knee Society Score were assessed pre- and postoperatively at 3 months.
  
  
  RESULTS
  Preoperative function was significantly lower in osteoarthritic patients with vitamin D deficiency (WOMAC score; p = 0.040), but at 3 months all functional scores were similar.
  
  
  CONCLUSIONS
  We concluded that vitamin D deficiency has a negative effect on function in knee osteoarthritic patients. However, postoperative vitamin D supplementation can lead to functional recovery in these patients. Thus, TKA should not be delayed in vitamin D deficient patients; rather supplementation in the postoperative period is preferable to achieve comparable functional outcome at 3 months to patients with vitamin D sufficiency.
authors.affiliation: Department of Orthopedics, Lilavati Hospital and Research Centre, Mumbai, India.
authors.forename: Rajesh Navin
authors.initials: RN
authors.lastname: Maniar
authors.affiliation: Department of Orthopaedics, Bharati Vidyapeeth Deemed University Medical College and Hospital, Pune, India.
authors.forename: Aniket Machindra
authors.initials: AM
authors.lastname: Patil
authors.affiliation: King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College, Mumbai, India.
authors.forename: Adit Rajesh
authors.initials: AR
authors.lastname: Maniar
authors.affiliation: Department of Orthopaedics, MGM New Bombay Hospital, Mumbai, India.
authors.forename: Bharat
authors.initials: B
authors.lastname: Gangaraju
authors.affiliation: Department of Orthopaedics, Agarwal Ramkrishna Care Hospital, Raipur, India.
authors.forename: Jaivardhan
authors.initials: J
authors.lastname: Singh
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000502:physiology* / Q000601:surgery; D008297:Male; D016059:Range of Motion, Articular; D011795:Surveys and Questionnaires; D014807:Vitamin D / Q000097:blood*
chemical_list: D014807:Vitamin D
keywords: Deficiency; Knee replacement arthroplasty; Osteoarthritis; Vitamin D