Vitamin D supplementation in pre and post-operative orthopaedic patients – a single centre study
Journal Title: Journal of Bone and Joint Diseases - Year 2017, Vol 0, Issue 0
Abstract
Background: The best-known role of vitamin D is its role in calcium homeostasis; appropriate serum calcium concentrations are essential for many functions, including proper mineralization of the bone, muscle contraction, and transmission of nerve impulses. Hypovitaminosis D leads to the delayed bone formation and healing may account for the findings in patients with nonunion. Material and methods: This prospective study was conducted in the department of orthopaedics in S N Medical College, Agra, India. 920 patients from both sexes between 20 to 80 years were included in this study. These 920 patients were divided into two groups, group A of 470 patients was supplemented by 60000 IU/week orally active vitamin D for 3 months, while group B of 450 patients was supplemented by placebo for 3 months. Each patient was assessed clinically after 15 days and serum markers including 25(OH)D, total calcium, inorganic phosphate, intact parathyroid hormone(PTH-i), alkaline phosphates and 1,25(OH)2D were reassessed after 3 months . Results: After 3 month of vitamin D supplementation parathyroid hormone (i-PTH) level decreased to 33.7 pg/ml from 41.2 in group A, while in placebo supplemented patients (group B), it remains 39.7pg/ml. The insignificant difference (p<.3343) between two groups became significant (p<.0001), which shows parathyroid hormone decreased abruptly when vitamin D was supplemented adequately). Patients who were presented with fracture and pain in their hip and knee region assessed radiologically and biochemically. They are again assessed radiologically after 3months of vitamin D supplementation, their x-rays show signs of healing and pain relief better in group A than group B. Conclusion: Vitamin D is responsible for fracture healing, various neuro-muscular abnormalities like pain in multiple joints, muscle weakness (proximal muscles mostly involved) leads to imbalance and difficulty in walking and these signs and symptoms are directly related with serum 25(OH)D. After 60000 IU/week vitamin D supplementation in vitamin D deficient patients, 25(OH)D was elevated at a significant level and all complaints due to deficiency were subsided gradually.
Authors and Affiliations
Chandra Prakash Pal, Ashwani Sadana, K. S. Dinkar, Rajat Kapoor, Lokesh Kumar Singh
Keywords
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