Hypovitaminosis D in Adolescents with Connective Tissue Injuries - - PowerPoint PPT Presentation

Hypovitaminosis D in Adolescents with Connective Tissue Injuries

Jennifer Kurowicki, M.D.

Todd P. Pierce, M.D.; Kimona Issa, M.D.; Peter Goljan, M.D.; Anthony Festa, M.D.; Vincent K. McInerney, M.D.; Anthony J. Scillia, M.D. Orthopaedic Summit Evolving Techniques: Residents & Fellows Summit 2017

Acknowledgements: Erica Simone, ATC; Rachel King, ATC; Kristen DeWilde, MS

Background

• Insufficient serum vitamin D

levels has been linked to poorer functional outcomes, patient reported outcomes, periprosthetic joint infection, and increased risk of severe fracture

• 2012 CDC National Health and

Nutrition Examination Survey

• 9% of children have a serum

hydroxy-vitamin D [25(OH)D] <15ng/mL

• 61% of children between 15-

29ng/mL

• The purpose of this study was to

assess vitamin D levels of adolescent athletes with cartilaginous, tendon or ligamentous injury

Methods

• Retrospective and prospective review of a single

institution’s medical records

• Serum 25 hydroxy-vitamin D [25(OH)D]
• Inclusion:
• Age <23 years
• Ligament, tendon, or cartilaginous injury
• If surgery necessary, lab result must be obtained

prior to surgery

• Exclusion:
• Age >23
• History of chronic illness
• History of immune modulation medication or

immune deficiency disease

• History of kidney or liver disease

Endocr crine S Society C Clinical Guidelines

Vitamin D deficiency: serum 25(OH)D of <20ng/mL

1

Vitamin D insufficiency: serum 25(OH)D of 21 to 29ng/mL

2

Vitamin D sufficiency: serum 25(OH)D of 30 to 100ng/mL

3

Res esult lts

• 73 patients
• 37 males and 36 females
• Mean age of 17 years (SD 2; range, 11.4 to 23.5 years)
• The mean 25(OH)D for the entire cohort was 27.9 ng/mL

(SD 11; range, 5.7 to 83.1 ng/mL)

• Males having a mean 25(OH)D of 29.2 ng/mL (SD 13; range, 9.4

to 83.1 ng/mL)

• Females was 26.5 ng/mL (SD 8; range, 5.7 to 45.5 ng/mL;

p=0.2956)

• Forty-seven (64.4%) patients had 25(OH)D levels below the

minimum recommendation of 30 ng/mL

• Fifteen (31.9%) were considered vitamin D deficient at <20

ng/mL

• Seasonality did not influence 25(OH)D levels amongst this cohort
• mean 25.5 ng/mL in fall/winter (n=34) vs. mean 30ng/mL in

spring/summer (n=39); p=0.0773)

Res esults: s: Me Mean 25 25-Hydrox

• xy

Vita tamin D D [25( 5(OH)D] L ] Lev evels by by Injur ury T Type

Conclusions

• Majority of adolescents with tendon,

ligamentous or cartilaginous injuries, regardless

• f gender or season, have serum 25-hydroxy-

vitamin D levels below the minimum recommendation

• Further investigation into the role of vitamin D

in the bone-connective tissue interface is warranted.

Thank you!

Questions?