Vitamin D status in patients with knee or hip osteoarthritis in a Mediterranean country

Background

Vitamin D plays an important role in bone mineralization, remodeling, and maintenance and therefore its deficiency may be implicated in the pathogenesis of osteoarthritis (OA). Vitamin D status was evaluated in patients with knee or hip OA scheduled for joint replacement. The impact of anthropometric parameters such as gender, age, and body mass index on vitamin D levels was also examined. The study was conducted in a Mediterranean country (Greece).

Materials and methods

We included 164 patients with knee or hip OA scheduled for joint replacement in this study. Serum levels of 25-hydroxyvitamin D (vitamin D) were measured in routine blood samples taken from the patients at their pre-admission visit, a week before the operation, using radioimmunoassay.

Results

The majority of patients were vitamin D deficient (81.7 %); 15.2 % of them were vitamin D insufficient (hypovitaminosis). Only 3 % of patients were vitamin D sufficient. There was a significantly positive association between vitamin D levels and male gender.

Conclusion

These findings indicate a large percentage of vitamin D deficient patients with knee or hip OA, which is unexpected considering the high annual insolation in northern Greece. Many other possible predisposing factors for OA should be taken into consideration. Whether treatment with vitamin D supplements may provide beneficial effects to these patients and the stage of disease in which this treatment should commence remains an issue for further scientific investigation.

Level of evidence

Level IV.     

Progression of osteoarthritis of the knee after unilateral total hip arthroplasty: minimum 10-year follow-up study

Introduction  Patients undergoing total hip arthroplasty (THA) exhibit changes in the alignment of lower extremities following the procedure, and these changes may exert effects on other joints over the long-term. Therefore, we investigated the course of knee osteoarthritis in patients undergoing long-term follow up after THA, in addition to the relationship between the course of knee osteoarthritis and alignment of lower extremities. Materials and methods  We retrospectively performed radiographic evaluation of the course of knee osteoarthritis (OA) after THA. Thirty patients undergoing successful unilateral THA were followed for a minimum of 10 years. Results  Eleven (33%) subjects showed progression of medial tibiofemoral OA on the non-THA side, while only three (10%) showed progression on the THA side, and this difference was significant (P = 0.033). In addition, the mechanical axes on the THA side passed through more lateral regions of the tibial plateau than those on the non-THA side (P = 0.044). Conclusion  Medial tibiofemoral OA on the THA side was less likely to deteriorate than on the non-THA side. The reduced vulnerability to OA progression on the THA side may be due to the lower offset and resultant lateral shift in mechanical axes.     

高寒地区城市汉族人群膝骨关节炎情况调查

目的研究高寒地区膝关节骨关节炎的患病情况、影响因素及防治措施。方法采用整群随机抽样的方法对社区内年龄在41～70岁的具有常住户口的汉族人群,分期分批进行问卷调查、体格检查和X线摄片。结果共有522名被调查者合格,男253名,女269名,平均年龄53.4岁,诊断膝关节炎者共100人,平均患病率19.16%,男性为11.07%,女性为26.77%。各年龄组以61～65岁组患病率最高,为36.07%,膝关节各个部位患病率,内侧胫股关节(20.5%)>外侧胫股关节(13.31%)>髌股关节(8.91%)。左右两侧无明显的差异。双侧同时出现异常的患病率分别为18.39%,11.11%和6.32%。工作姿势即站、蹲、坐、弯腰以及烟酒和日常饮食习惯与本病缺乏相关性。结论高寒地区城市汉族人群膝关节骨关节炎患病率较高,且以61～70岁为最高,其患病率与姿势及烟酒和日常饮食习惯无关;膝关节骨关节炎的X线异常为对称性。     

膝骨性关节炎的综合治疗

自1998年1月至2001年1月采用关节内注射透明质酸钠配合关节持续被动活动(CPM)及功能锻炼治疗膝关节骨性关节炎患者64例100膝,近期疗效显著.